Jailed Balloon Technique Versus Jailed Wire Technique for Side Branch Ostium Protection in Bifurcation Lesions: Evidence from Three-dimensional Optical Coherence Tomography Analysis.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-08-21 eCollection Date: 2024-08-01 DOI:10.31083/j.rcm2508300

JianGuo Cui, Xun Wu, QinHua Jin, YunDai Chen

{"title":"Jailed Balloon Technique Versus Jailed Wire Technique for Side Branch Ostium Protection in Bifurcation Lesions: Evidence from Three-dimensional Optical Coherence Tomography Analysis.","authors":"JianGuo Cui, Xun Wu, QinHua Jin, YunDai Chen","doi":"10.31083/j.rcm2508300","DOIUrl":null,"url":null,"abstract":"Background: There is controversy regarding the effectiveness the of jailed wire technique (JWT) and jailed balloon technique (JBT) in preserving the side branch (SB) during treatment. This study compares the protective effect of JBT versus JWT on the SB ostium area in coronary bifurcation lesions using three-dimensional optical coherence tomography (3D-OCT).Methods: We obtained data from coronary heart disease patients who received OCT-guided percutaneous coronary intervention (PCI) for bifurcation lesions. The SB protection strategies were divided into JWT and JBT, with the latter further subdivided into active JBT (A-JBT) and conventional JBT (C-JBT). The primary endpoint was the SB ostium area difference measured by 3D-OCT before and after PCI. Partial correlation analysis and propensity score matching (PSM) was used to mitigate confounding biases.Results: A total of 207 bifurcation lesions from 191 patients were analyzed, including 136 lesions treated with JWT and 71 lesions treated with JBT. The SB ostium area was significantly greater in the JBT group compared to the JWT group (0.41 <math><mo>±</mo></math> 1.22 mm2 vs. -0.25 <math><mo>±</mo></math> 1.40 mm2, p = 0.001). Following 1:1 PSM to adjust for 60 pairs, the difference between groups was not statistically significant (0.28 <math><mo>±</mo></math> 1.06 mm2 vs. -0.02 <math><mo>±</mo></math> 1.29 mm2, p = 0.165). Subgroup analysis revealed that A-JBT provided superior protection in both true (0.47 <math><mo>±</mo></math> 1.22 mm2 vs. -0.10 <math><mo>±</mo></math> 1.10 mm2, p = 0.011) and non-true bifurcation lesions (0.56 <math><mo>±</mo></math> 1.43 mm2 vs. -0.38 <math><mo>±</mo></math> 1.62 mm2, p = 0.030) over JWT, while C-JBT provided protection similar to JWT. A positive partial correlation was observed between the diameter of the jailed balloon and the increase in SB ostium area (r = 0.296, p = 0.013).Conclusions: Overall, A-JBT, but not C-JBT, provided better protection in bifurcation lesions compared to JWT. The larger diameter of the jailed balloon, rather than the application of higher pressure, enhanced the SB protection.","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366982/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.31083/j.rcm2508300","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: There is controversy regarding the effectiveness the of jailed wire technique (JWT) and jailed balloon technique (JBT) in preserving the side branch (SB) during treatment. This study compares the protective effect of JBT versus JWT on the SB ostium area in coronary bifurcation lesions using three-dimensional optical coherence tomography (3D-OCT).

Methods: We obtained data from coronary heart disease patients who received OCT-guided percutaneous coronary intervention (PCI) for bifurcation lesions. The SB protection strategies were divided into JWT and JBT, with the latter further subdivided into active JBT (A-JBT) and conventional JBT (C-JBT). The primary endpoint was the SB ostium area difference measured by 3D-OCT before and after PCI. Partial correlation analysis and propensity score matching (PSM) was used to mitigate confounding biases.

Results: A total of 207 bifurcation lesions from 191 patients were analyzed, including 136 lesions treated with JWT and 71 lesions treated with JBT. The SB ostium area was significantly greater in the JBT group compared to the JWT group (0.41 $\pm$ 1.22 mm² vs. -0.25 $\pm$ 1.40 mm², p = 0.001). Following 1:1 PSM to adjust for 60 pairs, the difference between groups was not statistically significant (0.28 $\pm$ 1.06 mm² vs. -0.02 $\pm$ 1.29 mm², p = 0.165). Subgroup analysis revealed that A-JBT provided superior protection in both true (0.47 $\pm$ 1.22 mm² vs. -0.10 $\pm$ 1.10 mm², p = 0.011) and non-true bifurcation lesions (0.56 $\pm$ 1.43 mm² vs. -0.38 $\pm$ 1.62 mm², p = 0.030) over JWT, while C-JBT provided protection similar to JWT. A positive partial correlation was observed between the diameter of the jailed balloon and the increase in SB ostium area (r = 0.296, p = 0.013).

Conclusions: Overall, A-JBT, but not C-JBT, provided better protection in bifurcation lesions compared to JWT. The larger diameter of the jailed balloon, rather than the application of higher pressure, enhanced the SB protection.

查看原文本刊更多论文

栓塞球囊技术与栓塞钢丝技术在分叉病变侧支骨膜保护中的应用：三维光学相干断层扫描分析的证据。

背景：关于栓塞钢丝技术（JWT）和栓塞球囊技术（JBT）在治疗过程中保护侧支（SB）的有效性存在争议。本研究使用三维光学相干断层扫描（3D-OCT）比较了 JBT 和 JWT 对冠状动脉分叉病变中 SB 支的保护作用：我们获得了在 OCT 引导下接受经皮冠状动脉介入治疗（PCI）治疗分叉病变的冠心病患者的数据。SB保护策略分为JWT和JBT，后者又分为主动JBT（A-JBT）和传统JBT（C-JBT）。主要终点是PCI前后通过3D-OCT测量的SB骨膜面积差异。采用部分相关性分析和倾向评分匹配（PSM）来减轻混杂偏倚：共分析了191名患者的207个分叉病变，其中136个病变接受了JWT治疗，71个病变接受了JBT治疗。与 JWT 组相比，JBT 组的 SB 管腔面积明显更大（0.41 ± 1.22 mm2 vs. -0.25 ± 1.40 mm2，p = 0.001）。经过 1:1 PSM 调整 60 对后，组间差异无统计学意义（0.28 ± 1.06 mm2 vs. -0.02 ± 1.29 mm2，p = 0.165）。亚组分析显示，A-JBT 对真实病变（0.47 ± 1.22 mm2 vs. -0.10 ± 1.10 mm2，p = 0.011）和非真实分叉病变（0.56 ± 1.43 mm2 vs. -0.38 ± 1.62 mm2，p = 0.030）的保护效果均优于 JWT，而 C-JBT 的保护效果与 JWT 相似。囚禁球囊的直径与 SB 骨膜面积的增加呈部分正相关（r = 0.296，p = 0.013）：总体而言，与 JWT 相比，A-JBT（而非 C-JBT）能更好地保护分叉病变。更大直径的锚定球囊，而不是应用更高的压力，增强了对 SB 的保护。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.