In the setting of single stent strategy for treatment of bifurcation, we investigate to compare simple strategy as "provisional final kissing balloon technique(fKBT)" to complex one as "routine FKBT", focusing on actual myocardial ischemia assessed by scintigraphy in 7-month and to examine optimal endpoint of side branch ostium.
Final kissing balloon technique (FKBT) is effective and accepted technique for the treatment of bifurcation. However, in complex lesion or anatomy, much procedure-time and contrast media are needed to accomplish this technique. Recent FFR study for jailed side branch (SB) demonstrated that angiographic severe stenosis at SB ostium includes "pseudo-stenosis" and stent-deployment jailing SB without FKBT has comparable impact on clinical outcome with FKBT strategy. Considering simple technique for bifurcation, we sought to investigate to compare "provisional FKBT" with "routine FKBT", focusing on actual myocardial ischemia assessed by scintigraphy in 7 month and to examine optimal endpoint of SB ostium.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
120
Provisional use of fKBT only when SB flow is aggravated to TIMI0-2 after stenting for non-left main bifurcation. Additional stenting for SB is recommended if residual stenosis (\>50% in visual) or TIMI flow grade (\<TIMI 3) was seen at SB after fKBT. Stent type: Everolimus-eluting stent only
Mandatory use of fKBT irrespective of SB flow after stenting for non-left main bifurcation. Additional stenting for SB is recommended if residual stenosis (\>50% in visual) or TIMI flow grade (\<TIMI 3) was seen at SB after fKBT. Stent type: Everolimus-eluting stent only
Edogawa Hospital
Tokyo, Japan
Saiseikai Yokohama City Eastern Hospital
Yokohama, Japan
Rate of positive dipyridamole stress technetium scintigraphy
Time frame: 7 month
Composite of major cardiac adverse events(MACE)
Including cardiac death,myocardial infarction, stent thrombosis and target vessel revascularization
Time frame: 8 month
Angiographic restenosis rate in main vessel
Time frame: 8 month
Fluoroscopic time
Time frame: after procedure
Amount of contrast media
Time frame: after procedure
Number of stent and wire use
Time frame: after procedure
Diameter stenosis and late loss in side branch
Time frame: 8 month
Regional summed difference score
Time frame: 7 month
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