Acute Angiographic and Intermediate-Term Clinical Results of Patients with Non-Left Main Coronary Bifurcation Lesions Treated with BVS by Jailed Semi-Inflated Balloon Technique and Provisional Side-Branch Stenting Strategy

Figure 1

The steps of drug-eluting stent (DES) implantation for a complex bifurcation lesion using the jailed semiinflated balloon technique (JSIBT). (a) Diagnostic coronary angiography (CAG) at anteroposterior and cranial 33° projection showed a true distal left anterior descending (LAD) artery bifurcation lesion (white arrow, Medina classification 1.1.1). (b) Wiring of the main vessel (MV) LAD and side branch (SB), and balloon dilatation of the MV. (c) Balloon dilatation of the diagonal side branch (SB). (d) CAG postballoon dilatation of both the MV and SB revealed significant stenosis of both branches. (e) Placement of a semicompliant balloon in the diagonal SB and DES in distal LAD, covering the MV lesion. (f) DES and a semicompliant balloon were inflated simultaneously. The SB balloon was inflated at low pressure (6 atmospheres) and DES at less than nominal pressures. (g) For optimization of the MV stent, the proximal optimal technique was performed with a short noncompliant balloon. (h) Final CAG at LAO 6° and Cranial 28° projection showed a good angiographic result and bifurcation flow.