Should kissing balloon inflation after main vessel stenting be routine in the one-stent approach? A systematic review and meta-analysis of randomized trials.

The KBI (kissing balloon inflation) technique is considered the default strategy for the two-stent approach in real world practice. Studies comparing KBI and No-KBI in patients undergoing the one-stent approach have reported conflicting results. The meta-analysis was performed to compare the clinica...

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Main Authors: Ming Zhong, Biao Tang, Qiang Zhao, Jian Cheng, Qiangsong Jin, Shenwen Fu
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2018-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC6021082?pdf=render
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spelling doaj-0a9adb2c9c754ecead915ca35d817dc32020-11-25T01:53:42ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01136e019758010.1371/journal.pone.0197580Should kissing balloon inflation after main vessel stenting be routine in the one-stent approach? A systematic review and meta-analysis of randomized trials.Ming ZhongBiao TangQiang ZhaoJian ChengQiangsong JinShenwen FuThe KBI (kissing balloon inflation) technique is considered the default strategy for the two-stent approach in real world practice. Studies comparing KBI and No-KBI in patients undergoing the one-stent approach have reported conflicting results. The meta-analysis was performed to compare the clinical outcomes of the KBI strategy and the No-KBI strategy for coronary bifurcation lesions in the one-stent approach. Five randomized studies were included, and a total of 1264 patients were involved in the meta-analysis. The primary outcome was cardiac death. The secondary end points were stent thrombosis, MI (myocardial infarction), target lesion revascularization (TLR), target vessel revascularization (TVR), and main vessel and side branch restenosis. Compared with the No-KBI strategy, the KBI strategy was associated with a significant reduction in side branch restenosis (OR: 0.44, 95% CI: 0.30-0.64, p<0.001). A high risk of main vessel restenosis was found in the KBI group (OR: 2.96, 95% CI: 1.74-5.01, p<0.001). There were no significant differences in rates of cardiac death (OR: 1.89, 95% CI: 0.60-5.95, p = 0.28), stent thrombosis (OR: 0.98, 95% CI: 0.19-4.94, p = 0.98), MI (OR: 0.68, 95% CI: 0.33-1.44, p = 0.30), TLR (OR 1.14, 95% CI 0.68-1.90, p = 0.62), or TVR (OR 1.27, 95% CI 0.75-2.16, p = 0.38). Compared with the No-KBI strategy, the KBI strategy reduced the incidence of side branch restenosis and increased the risk of main branch restenosis in the one-stent approach. However, the clinical outcomes were similar between the KBI and No-KBI groups.http://europepmc.org/articles/PMC6021082?pdf=render
collection DOAJ
language English
format Article
sources DOAJ
author Ming Zhong
Biao Tang
Qiang Zhao
Jian Cheng
Qiangsong Jin
Shenwen Fu
spellingShingle Ming Zhong
Biao Tang
Qiang Zhao
Jian Cheng
Qiangsong Jin
Shenwen Fu
Should kissing balloon inflation after main vessel stenting be routine in the one-stent approach? A systematic review and meta-analysis of randomized trials.
PLoS ONE
author_facet Ming Zhong
Biao Tang
Qiang Zhao
Jian Cheng
Qiangsong Jin
Shenwen Fu
author_sort Ming Zhong
title Should kissing balloon inflation after main vessel stenting be routine in the one-stent approach? A systematic review and meta-analysis of randomized trials.
title_short Should kissing balloon inflation after main vessel stenting be routine in the one-stent approach? A systematic review and meta-analysis of randomized trials.
title_full Should kissing balloon inflation after main vessel stenting be routine in the one-stent approach? A systematic review and meta-analysis of randomized trials.
title_fullStr Should kissing balloon inflation after main vessel stenting be routine in the one-stent approach? A systematic review and meta-analysis of randomized trials.
title_full_unstemmed Should kissing balloon inflation after main vessel stenting be routine in the one-stent approach? A systematic review and meta-analysis of randomized trials.
title_sort should kissing balloon inflation after main vessel stenting be routine in the one-stent approach? a systematic review and meta-analysis of randomized trials.
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2018-01-01
description The KBI (kissing balloon inflation) technique is considered the default strategy for the two-stent approach in real world practice. Studies comparing KBI and No-KBI in patients undergoing the one-stent approach have reported conflicting results. The meta-analysis was performed to compare the clinical outcomes of the KBI strategy and the No-KBI strategy for coronary bifurcation lesions in the one-stent approach. Five randomized studies were included, and a total of 1264 patients were involved in the meta-analysis. The primary outcome was cardiac death. The secondary end points were stent thrombosis, MI (myocardial infarction), target lesion revascularization (TLR), target vessel revascularization (TVR), and main vessel and side branch restenosis. Compared with the No-KBI strategy, the KBI strategy was associated with a significant reduction in side branch restenosis (OR: 0.44, 95% CI: 0.30-0.64, p<0.001). A high risk of main vessel restenosis was found in the KBI group (OR: 2.96, 95% CI: 1.74-5.01, p<0.001). There were no significant differences in rates of cardiac death (OR: 1.89, 95% CI: 0.60-5.95, p = 0.28), stent thrombosis (OR: 0.98, 95% CI: 0.19-4.94, p = 0.98), MI (OR: 0.68, 95% CI: 0.33-1.44, p = 0.30), TLR (OR 1.14, 95% CI 0.68-1.90, p = 0.62), or TVR (OR 1.27, 95% CI 0.75-2.16, p = 0.38). Compared with the No-KBI strategy, the KBI strategy reduced the incidence of side branch restenosis and increased the risk of main branch restenosis in the one-stent approach. However, the clinical outcomes were similar between the KBI and No-KBI groups.
url http://europepmc.org/articles/PMC6021082?pdf=render
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