Simultaneous kissing stents (SKS)

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Simultaneous kissing stents (SKS)

Simultaneous kissing stents (SKS) are used in the treatment of coronary bifurcation lesions in situations where the need for a future side branch access is deemed unlikely. If future side branch access is needed, it is likely that a guide wire may pass through the struts of one wire and cross over to the other stent while negotiating the neo-carina. The difference between a V stenting and simultaneous kissing stent is basically that the protrusion into the proximal segment is typically more than 5 millimeters so that a new carina is formed within the parent vessel with a double barrel of stents. In the SKS technique, both branches are initially wired and dilated. Then two parallel stents are placed in both branches, extending into the proximal segment of the main branch. One stent is initially inflated, followed by the other stent. Finally a kissing balloon inflation is done in both stents together using same pressure for both stents.

Paul D Morris, Javaid Iqbal, Claudio Chiastra, Wei Wu, Francesco Migliavacca and Julian P Gunn studied SKS in unprotected left main bifurcation disease [1]. They concluded that SKS in unprotected left main disease does not distort the stents and is associated with favourable hemodynamics. There is tissue coverage of the exposed struts and low rates of restenosis. Repeat intervention if needed, with a repeat SKS appeared feasible, safe and durable.

Reference

  1. Paul D Morris, Javaid Iqbal, Claudio Chiastra, Wei Wu, Francesco Migliavacca, Julian P Gunn. Simultaneous Kissing Stents to Treat Unprotected Left Main Stem Coronary Artery Bifurcation Disease; Stent Expansion, Vessel Injury, Hemodynamics, Tissue Healing, Restenosis, and Repeat Revascularization. Catheter Cardiovasc Interv. 2018 Nov 15;92(6):E381-E392.