INTRODUCTION: Bifurcated coronary lesions are still a challenge to the percutaneous treatment, with a lower than expected success rate and high rates of restenosis. The pull-back technique is an option for the treatment of coronary lesions in bifurcations that compromises exclusively the ostium of lateral branches, but its middle term results are still not known. The aim of this study is to assess the initial and 6-month angiographic results of this technique in our casuistic. METHOD: The technique consists in the positioning of two guide-wires, followed by the stent in the lateral branch and the balloon in the main vessel, covering the origin of the branch. After insufflating the balloon in the main vessel, the stent is pulled back towards the main vessel until it touches the balloon, and then implanted. RESULTS: Thirty-seven consecutive patients were treated. The diagonal branches were the most commonly treated (70.3%). The reference diameter of the lateral branches was 2.51 ± 0.37 mm and the extension of the lesion 11.1 ± 3.7 mm. The release pressure of the stents within the lateral branch was 12.8 ± 1.9 atm and the insufflation pressure of the balloon in the main vessel was 7.8 ± 0.9 atm. The stent was successfully implanted in all procedures. Twenty-two (59.5%) patients were submitted to late coronariography and restenosis was observed in the lateral branch in 9 (40.9%) patients, and the development of lesions > 50% in the main vessel was observed in 7 (31.8%) patients. CONCLUSION: Isolated lesions found in the ostial of lateral branches treated with the "pull-back" stent implantation technique presented high rates of procedural success. However, in the middle term follow-up, a high restenosis rate in the lateral branch was observed, as well as a high risk of developing a new obstruction in the main vessel.
Stents; Angioplasty, transluminal, percutaneous coronary; Coronary disease
