Archivos de cardiologia de Mexico · 2026
[Jailed balloon versus provisional stenting with drug-coated balloon in true bifurcation lesions].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Macías-Argüelles Dafne M, Bautista-López Germán R, Macías-Cervantes Hilda E, Sánchez-López José M, Castillo-Velázquez Mario A, Solórzano-Vázquez Marco A, Cibrián-Delgado Juan A, Quintana-Ortiz Edgar U, Bernal-Ruíz Enrique A, Vargas-Ramírez Luis M
Аннотация
BACKGROUND: Coronary bifurcation lesions remain a major challenge in percutaneous coronary intervention because of the risk of side branch compromise or occlusion. Several strategies, including provisional stenting, jailed balloon protection, and drug-coated balloons, have been developed to preserve side branch patency; however, direct comparative evidence in true bifurcation lesions remains limited.
OBJECTIVE: To determine the frequency of side branch compromise in coronary bifurcation lesions treated with jailed balloon technique versus provisional stenting plus drug-coated balloon.
METHOD: Open-label randomized clinical trial conducted at UMAE No. 1 Bajío, IMSS, from April to September 2025. A total of 32 patients with acute or chronic coronary syndrome and true bifurcation lesions (Medina 1-1-1, 1-0-1, 0-1-1) were randomized 1:1 to provisional stenting with drug-coated balloon or jailed balloon. The primary endpoint was side branch compromise (occlusion, > 90% ostial pinching, or dissection > A). Clinical, angiographic, and procedural outcomes were analyzed.
RESULTS: Sixteen patients were allocated to each technique. Baseline characteristics were similar. Both strategies achieved universal angiographic success (TIMI 3 flow in all cases). Conversion to two stents was infrequent (three cases). Contrast use per treated vessel was significantly lower with the jailed balloon technique (56.7 vs 115.0 ml; p = 0.0016). No major adverse events were reported during early follow-up.
CONCLUSIONS: Both strategies proved safe and effective for true bifurcation lesions, even in high-risk patients. The jailed balloon technique offered the additional advantage of significantly reducing contrast use, which may be especially beneficial in patients at risk of contrast-induced nephropathy.
OBJECTIVE: To determine the frequency of side branch compromise in coronary bifurcation lesions treated with jailed balloon technique versus provisional stenting plus drug-coated balloon.
METHOD: Open-label randomized clinical trial conducted at UMAE No. 1 Bajío, IMSS, from April to September 2025. A total of 32 patients with acute or chronic coronary syndrome and true bifurcation lesions (Medina 1-1-1, 1-0-1, 0-1-1) were randomized 1:1 to provisional stenting with drug-coated balloon or jailed balloon. The primary endpoint was side branch compromise (occlusion, > 90% ostial pinching, or dissection > A). Clinical, angiographic, and procedural outcomes were analyzed.
RESULTS: Sixteen patients were allocated to each technique. Baseline characteristics were similar. Both strategies achieved universal angiographic success (TIMI 3 flow in all cases). Conversion to two stents was infrequent (three cases). Contrast use per treated vessel was significantly lower with the jailed balloon technique (56.7 vs 115.0 ml; p = 0.0016). No major adverse events were reported during early follow-up.
CONCLUSIONS: Both strategies proved safe and effective for true bifurcation lesions, even in high-risk patients. The jailed balloon technique offered the additional advantage of significantly reducing contrast use, which may be especially beneficial in patients at risk of contrast-induced nephropathy.