Modified Jailed Balloon Technique for Coronary Bifurcation Lesions

Background and Objective: Side branch occlusion brings with a serious complication and occurs in more than 7.0% of cases during bifurcation stenting. We propose a new technique, Modified Jailed Balloon Technique (M-JBT), to prevent it.
Methods: A jailed balloon (JB) is introduced into the side branch (SB), while a stent is placed in the main branch (MB) as crossing SB. The size of JB is half of MB stent size. While the proximal end of JB attaching to MB stent, both stent and JB are simultaneously inflated with same pressure. Then, JB is removed and guidewires are re-crossed. Kissing balloon dilatation (KBD) and/or T And Protrusion (TAP) stenting are applied as needed. We also applied bench test to confirm the effectiveness of M-JBT.
Results: 128 patients (136 bifurcation lesions including 29 left main trunk disease) underwent percutaneous coronary intervention (PCI) using this technique. Procedure success was achieved in all cases. KBD was performed for 102 lesions and TAP stenting was employed for 16 lesions. Occlusion of SV was not observed in any of the patients. Bench test confirmed less deformity of MB stent in M-JBT compared with conventional-JBT.
Conclusions: This novel M-JBT is safe and effective in the preservation of SB patency during bifurcation stenting.