Systematic review and meta-analysis compares jailed balloon versus jailed wire techniques for bifurcation PCI

Photo by DIANA HAUAN / Unsplash

The American journal of cardiology Published May 15, 2026 Medically reviewed May 15, 2026 Study authors: Lee Jonathan Vincent, Emmanuela Mirela, Patricio Andrew, Theja Dimetrio Alonzo, Lee Jonathan Bryan, … PubMed ↗ DOI ↗ By Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

Key Takeaway

Consider jailed balloon technique for reduced side-branch occlusion risk in bifurcation PCI.

This systematic review and meta-analysis compared the jailed balloon technique (JBT) with the jailed wire technique (JWT) for treating coronary bifurcation stenosis. The pooled analysis included data from 2,329 patients undergoing bifurcation percutaneous coronary intervention. The primary outcome assessed was procedure-related adverse events, including side-branch occlusion, coronary dissection, and peri-procedural myocardial infarction. Secondary outcomes included all-cause mortality, cardiac death, target-lesion revascularization, and major adverse cardiovascular events (MACE).

The meta-analysis found that the JBT group had a lower risk of side-branch occlusion compared to the JWT group. The odds ratio was 0.31 with a 95% confidence interval of 0.20 to 0.48 and a p-value less than 0.00001. No significant differences were observed between the two techniques for coronary dissection, peri-procedural myocardial infarction, all-cause mortality, cardiac death, target-lesion revascularization, or major adverse cardiovascular events (MACE).

Safety data regarding adverse events, serious adverse events, discontinuations, and tolerability were not reported in the source. The authors note that while JBT offers a benefit for side-branch occlusion, the techniques are comparable for other clinical endpoints. Practice relevance is limited by the absence of reported safety data and the specific procedural context of bifurcation interventions.

Study Details

Study typeMeta analysis

Sample sizen = 2,329

EvidenceLevel 1

PublishedMay 2026

PMID41771329

View Original Abstract ↓

Bifurcation percutaneous coronary intervention (PCI) remains technically challenging and is considered high risk to procedural complications, particularly side branch (SB) occlusion. The jailed wire technique (JWT) is commonly recommended for SB protection; however, it does not fully prevent the complication. The jailed balloon technique (JBT) was introduced to provide more active protection, but previous evidence has been inconsistent. This study aimed to provide updated evidence on the effectiveness of JBT versus JWT for SB protection during bifurcation PCI. PubMed, ScienceDirect, and the Cochrane Library were searched for randomized trials and cohort studies comparing JBT and JWT in patients undergoing bifurcation PCI. The primary end points were procedure-related adverse events, including SB occlusion, coronary dissection, and peri-procedural myocardial infarction. Secondary end points included all-cause mortality, cardiac death, target-lesion revascularization, and major adverse cardiovascular events (MACE). Odds ratios with 95% confidence intervals were calculated as a measure. Study quality was assessed using the Newcastle-Ottawa Scale and risk of bias 2.0 tool. Ten studies involving 2,329 patients were included (793 JBT and 1,536 JWT). The risk of SB occlusion was lower in JBT group compared to JWT group (odds ratio = 0.31, 95% confidence interval 0.20 to 0.48; p <0.00001). There were no significant differences between the 2 techniques in coronary dissection, peri-procedural myocardial infarction, all-cause mortality, cardiac death, target-lesion revascularization, or MACE. All studies were considered good quality. In conclusion, the use of JBT was associated with a reduced risk of SB occlusion during bifurcation PCI, while both techniques demonstrated comparable outcomes for other procedural and long-term clinical outcomes.