Kissing Balloon Inflation in Percutaneous Coronary Interventions

Dr. Burak Kardeşler

Bilkent City Hospital, Department of Cardiology, Ankara, Türkiye

ABSTRACT

The kissing balloon (KB) technique is a pivotal approach in managing coronary bifurcation lesions, which make up about 20% of coronary interventions. These lesions present a unique challenge due to the anatomy involving a main vessel (MV) and a side branch (SB), which increases the risk of complications like restenosis and side branch occlusion. The KB technique was introduced to address these issues by allowing simultaneous balloon inflation in both MV and SB, ensuring side branch access, improving stent apposition, and preventing stent deformation. Historically, the KB technique was first applied to peripheral interventions before adapting for coronary bifurcation treatment, with advancements such as drug-eluting stents enhancing its success. KB inflation requires precision in selecting balloon size, inflation pressure, and deflation sequence, as improper techniques can lead to stent deformation, especially in complex bifurcation cases. Studies, including the Brit- ish Bifurcation Coronary Study, highlight the effectiveness of KB inflation in optimizing stent placement, with success rates reaching up to 95% in simpler cases. Imaging modalities like intravascular ultrasound and optical coherence tomography further affirm its role in achieving proper stent apposition and reducing side branch restenosis. Nonetheless, KB inflation may be unnecessary in simpler cases and adds procedural complexity and time in certain scenarios. While the KB technique is highly beneficial, it carries risks, including potential stent deformation and complications in patients with specific medical conditions. Future advances in imaging and technology are expected to refine the KB technique and enhance long-term outcomes.

Keywords: Angioplasty; Balloon; Coronary; Treatment outcome; Ultrasonography; Interventional; Tomography; Optical Coherence

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