The Anatolian Journal of Cardiology
Original Investigation

Evaluation of Long-Term Outcomes of Crossover or Focal Ostial Stenting of Left Anterior Descending Artery Ostial Stenosis

1.

Department of Cardiology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey

2.

Department of Cardiology, Memorial Bahçelievler Hospital, İstanbul, Turkey

3.

Department of Cardiology, Faculty of Medicine, İstanbul Aydın University, VM Florya Medical Park Hospital, İstanbul, Turkey

4.

Department of Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey

Anatol J Cardiol 2022; 26: 827-831
DOI: 10.5152/AnatolJCardiol.2022.1122
Read: 125 Downloads: 68 Published: 01 November 2022

Background: Optimal management of patients with ostial left anterior descending artery stenosis remains an unresolved issue.

Methods: Patients with ostial left anterior descending stenosis who underwent stent implantation were included in this study. Coronary records of all patients were monitored, and long-term clinical outcomes were recorded. The patients were divided into 2 groups according to the stenting method: focal left anterior descending stenting [ostial stenting group] and stenting from the left main coronary artery to the left anterior descending [crossover stenting group].

Results: Of the 97 eligible consecutive patients, 56 were treated with ostial stenting and 41 with crossover stenting. At a mean follow-up of 23.6 ± 12.6 months, non-fatal myocardial infarction (3.9% vs. 12.8%, P=.118), target lesion revascularization (5.9% vs. 12.8%, P=.252), and all-cause death (2.0% vs. 7.7%, P=.191) rates were not statistically significant. However, the rate of major adverse cardiovascular events defined as a composite of non-fatal myocardial infarction, target lesion revascularization, or all-cause death was significantly higher in the crossover stenting group (8.2% vs. 28.2%, P = .013). In the multiple regression analysis, left main coronary artery diameter (odds ratio = 4.506; 95% CI: 1.225-16.582, P = .024) and application of the crossover stenting technique (odds ratio = 5.126; 95% CI: 1.325-19.833, P = .018) were found to be the most effective predictors of major adverse cardiovascular events.

Conclusion: In our study, the ostial stenting group was associated with better clinical outcomes in the treatment of ostial left anterior descending stenosis. However, it is notappropriate to apply a single method to all patients with such lesions.

Cite this article as: Soylu K, Yıldırım U, Nasifov M, et al. Evaluation of long-term outcomes of crossover or focal ostial stenting of left anterior descending artery ostial stenosis. Anatol J Cardiol. 2022;26(11):827-831.

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ISSN 2149-2263 EISSN 2149-2271