RESUMEN
Background: Kissing Balloon Inflation (KBI) technique was the first technique for percutaneous intervention in bifurcation lesions. It's the standard strategy in the two-stent procedure. Its benefit in one-stent approach remains uncertain. Several trials comparing KBI strategy with the No-KBI strategy in one-stent technique did not show any advantages in the clinical outcome. Clinical outcome and the follow up of ischemic symptoms is a useful method to compare the effectiveness of both strategies.Aims: To study the short-term clinical outcome (3and 6 months) of provisional versus routine kissing‑balloon technique after main vessel stenting for coronary bifurcation lesions.Patients and Methods: The study included sixty consecutive patients. They were randomized to receive different side branch (SB) intervention strategies: group I (provisional final kissing balloon inflation group -PFKBI) (FKBI only when SB Flow less than TIMI 3) and group II (routine final kissing balloon inflation group –RFKBI).Results: 1-Dissection of side branchand conversion to two stent strategy was significantly higher in PFKBI group (14,3%) than in RFKBI group (0) 2-The amount of dye, total procedure time and time of admission was significantly higher in RFKBI group. 3-Chest pain immediately after the procedure was significantly higher in PFKBI group while at 3 and 6 months follow up no significant difference between both groups was noticed. 4-MACE, target lesion revascularization (TLR) and stent thrombosis were similar between both groups at 3 and 6 months.Conclusions: Main vessel stenting with and without final kissing balloon dilatation was associated with favorable and similar 3 and 6-month clinical outcomes
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Aim:This study aimed to compare between the effect ofpharmacoinvasive strategy (PI)& primary percutaneous coronary intervention (P-PCI) according to PCIrelated delay (door to ballon) on the mortality and morbidityduring in-hospital stay and after 30-day follow up. Moreover, leftventricular systolic function was assessed by two-dimensional echocardiography at cardiology department, Tanta University. Patients and Methods:The study was conducted on 300 patients that were dividedinto 2 main groups. Group A consisted of patients had primaryPCI as reperfusion therapy and further divided into threegroups according to PCI related delay (door toballon). Group A1, PCI-related delay is ≤60 minute(92patients). Group A2, PCI-related delay is >60 to ≤ 90 minute. (54patients). Group A3, PCI-related delay is >90minute (78 patients). The second group (group B), include patients who undergopharmaco-invasive strategy, PCI within 24 hour afterthrombolysis (76 patients). the second group, coronary angiography was done immediately in cases of failedthrombolysis and for successful thrombolysis; coronaryangiography was performed within 3 –24 hours. Results:During hospital stay, more patients in group A3 died than those of group B orgroup A1, A2 with no statistical significance.In addition, morepatients in group A3 showed heart failure symptoms withstatistical significance than those of group B, A1 and A2. Bleeding complications occurred significantly moreingroupB. Duringfollowupvisits more patients in group A3 complained ofheart failure symptoms with statistical significance than those of group B, A1, A2 patients. Conclusion:Primary PCIwithout door to balloon time delay (≤90 minutes)was encouraged and hadthebest results on morbidity and mortality. Also, pharmacoinvasive strategy was encouraged as being better than primary PCIwhen door to balloon time showed marked delay( <90 minutes)