Clinical evaluation of Szabo technique in percutaneous intervention for ostial lesions

AIM:To evaluate the safety and feasibility of Szabo technique used in treating lesions on the ostium of the coronary artery. METHODS: In a retrospective study, stenting was attempted using the Szabo technique, from October 2008 to October 2011. There were 16 patients (55.6±5.2 years; 87.5% male) corresponding to Medina 010/001 bifurcations or aorto-ostial lesions. After predilatation, the anchor guidewire (2GW) placed in the side branch was threaded through the most proximal stent cell and the stent was advanced into the target lesion until it was stopped at the carina. Stent was initially inflated at 6 atm and deflated, and after removing the 2GW, the delivery was completed at required atmospheres. All patients were followed up 3-12 months after surgery. Ten patients were rechecked by coronary arteriography after 6 months. RESULTS: The procedure was technically successful in 15 (93.8%) patients. In the remaining patient, a stent dislodged during the procedure due to the severely calcified vessel and the vessel was successfully stented using traditional techniques. Of all the lesions, nine were located in the ostium of the left anterior descending coronary arteries, two in the ostium of the right coronary artery, two in the ostium of the bifurcation of the left circumflex obtuse marginal branch, and two in the ostium of the posterior descending artery bifurcating the posterior lateral artery. Angina or other adverse cardiovascular events occurred in none of the 16 patients 3-12 months after procedures. CONCLUSION: Szabo technique can accurately implant a stent in Medina 010/001 bifurcations or in aorto-ostial lesions and thus reduce the incidence of angiographic malpositioning, but this technique runs the risk of stent dislodgement in severely calcified or tortuous lesions.