The article is accompanied by the editorial on page 894
After stent deployment in MV (sized according to the distal vessel🫰 diameter) the POKI technique includes the following steps: (1) Proximal optimization technique with a non-compliant (NC) balloon sized according to🫰 the proximal MV diameter; (2) SB recrossing with a wire and removal of jailed wire; (3) Kissing balloon inflation using🫰 a NC balloon in the SB, with proximal marker of the balloon into the stent borders and an NC POT🫰 balloon in the MV, with distal balloon marker positioned parallel to carina tip.
Dedicated bifurcation quantitative coronary angiography (QCA) analysis was🫰 performed according to the recommendation of the consensus on QCA methods for bifurcation lesions using General Electric QCA software and🫰 MicroDicom QCA software [13]. True bifurcation lesions were defined as visual percent diameter stenosis (%DS) > 50% at the SB.🫰 The minimal luminal diameter (MLD), reference vessel diameter (RVD), and %DS were measured for every segment of the bifurcation (i.e.,🫰 proximal, and distal MV and SB) pre-and post-intervention. Lesion length was measured from the proximal main vessel to the distal🫰 main branch (i.e., we considered beginning and ending points where hypothetically the stent will be implanted). SB lesion length was🫰 measured from the ostium to the first normal-appearing part of the vessel. All analyzes were performed by two investigators (N.M.🫰 and P.P.) and in case of disagreement, a consensus was formed with additional analysis from the first author (D.V.).
Bench simulation
The🫰 main findings of the present study are the following: i) A novel stent optimization technique combining proximal optimization balloon inflation🫰 and kissing balloon technique was introduced and was found to be feasible both in bench-test and in-vivo evaluation; ii) Procedural🫰 and angiographic success after POKI in the current patient series, was excellent; iii) The immediate angiographic result after the procedure🫰 was significantly better compared with previously reported data assessing stent optimization techniques in bifurcation lesions.
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