Objective To explore a new technique (stent kissing balloon, SKB) for the treatment of special ostial LAD stenosis.
Methods From January 2008 to March 2010, 8 patients were enrolled to this study, the including entry creteria were left anterior descending artery (LAD) ostial stenosis>70%, and with the angle between LAD and left circumflex artery (LCX) was less than 60°; left main artery diameter was much larger than LAD ostial diameter (>1 mm), at same time LCX ostial without obvious stenosis lesions. The key point of procedure was as follows: firstly, the stent in LAD and the balloon in LCX should arrive at the positions simultaneously. Secondly, the proximal marker of the balloon was a little ahead of the proximal marker of the stent, then first release the stent with high pressure (12–14 atm) and at last inflate the stent and balloon simultaneously (final kissing with 8–10 atm). Follow-up was carried out by outpatient, phone calls or coronary angiography.
Results The patients average age was 54.4±9.0 years, 6 was male, 2 was female, 3 patients with diabetes, four patients with hypertension, one patients with prior myocardial infarction, the characteristics of lesions was diffused in two patients and tubular in 6 patients. The average of diameter stenosis was 86±8%. All the patients accomplished clinical follow-up, average 590±202 days (268–810 days), there was no major adverse cardiac events (including target lesion revascularization, myocardial infarction and all-cause death), four patients accomplished 6–8 angiographic follow-up. There was no in-stent restenosis in these four patients.
Conclusions The SKB technique is safety and efficacy for the special ostial LAD lesions, long-term follow-up and large volume patients study is needed to verify the initial results.