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KMID : 0338420140290050597
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The Korean Journal of Internal Medicine
2014 Volume.29 No. 5 p.597 ~ p.602
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Long-term outcomes of simple crossover stenting from the left main to the left anterior descending coronary artery
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Lee Ho-Myung
Nam Chang-Wook
Cho Yun-Kyeong
Yoon Hyuck-Jun
Park Hyoung-Seob
Kim Hyung-Seop
Chung In-Sung
Heo Yun-Seok
Hur Seung-Ho
Kim Yoon-Nyun
Kim Kwon-Bae
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Abstract
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Background/Aims: Although complex bifurcation stenting in patients with nonleft main (LM) bifurcation lesions has not yielded better clinical outcomes than simpler procedures, the utility of complex bifurcation stenting to treat LM bifurcation lesions has not yet been adequately explored.
Methods: In the present study, patients who underwent LM-to-left anterior descending (LAD) coronary artery simple crossover stenting to treat significant de novo distal LM or ostial LAD disease, in the absence of angiographically significant ostial left circumflex (LCX) coronary artery disease, were consecutively enrolled. The frequencies of 3-year major adverse cardiovascular events (MACEs; cardiac death, myocardial infarction, and target lesion revascularization), were analyzed.
Results: Of 105 eligible consecutive patients, only 12 (11.4%) required additional procedures to treat ostial LCX disease after main vessel stenting. The mean percentage diameter of ostial LCX stenosis increased from 22.5% ± 15.2% to 32.3% ± 16.3% (p < 0.001) after LM-to-LAD simple crossover stenting. The 3-year incidence of MACEs was 9.7% (cardiac death 2.2%; myocardial infarction 2.2%; target lesion revascularization 8.6%), and that of stent thrombosis 1.1%. Of seven cases (7.5%) requiring restenosis, pure ostial LCX-related repeat revascularization was required by only two.
Conclusions: Simple crossover LM-to-LAD stenting without opening of a strut on the LCX ostium was associated with acceptable long-term clinical outcomes.
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KEYWORD
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Percutaneous coronary intervention, Coronary stenosis, Stents, Outcome
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