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July 19, 2022The Anatolian Journal of CardiologyOpen Access

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

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Why the study?

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

Does crossover stenting compared to focal ostial stenting reduce major adverse cardiovascular events in patients with ostial left anterior descending artery stenosis?

Population

97 consecutive patients with ostial left anterior descending stenosis undergoing stent implantation

Comparison

Focal ostial stenting vs crossover stenting from left main coronary artery to left anterior descending

Design

Observational cohort study

Follow-up

Mean 23.6 ± 12.6 months

Authors

KSKorhan SoyluUYUfuk YıldırımMNMuharrem Nasıfov

Discussion

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Overview

Focal ostial stenting was associated with lower MACE than crossover in ostial LAD stenosis; hypothesis-generating and should not yet change practice.

Structured PICO

Does crossover stenting compared to focal ostial stenting reduce major adverse cardiovascular events in patients with ostial left anterior descending artery stenosis?

P
Population
97 consecutive patients with ostial left anterior descending (LAD) artery stenosis who underwent stent implantation.
I
Intervention
Crossover stenting from the left main coronary artery to the left anterior descending artery (n=41).
C
Comparator
Focal ostial stenting of the left anterior descending artery (n=56).
O
Outcome
Major adverse cardiovascular events (MACE) defined as a composite of non-fatal myocardial infarction, target lesion revascularization, or all-cause death at a mean follow-up of 23.6 ± 12.6 months.composite

Focal ostial stenting was associated with significantly lower rates of major adverse cardiovascular events compared to crossover stenting in patients with ostial LAD stenosis, suggesting that a single crossover strategy is not appropriate for all patients.

Limitations

  • Retrospective analysis
  • Unmeasured confounders may have affected outcomes
  • Limited number of patients
  • Rare use of intravascular ultrasound (IVUS)

Cite This Study

Soylu et al. (2022) studied this question.

synapsesocial.com/papers/6a19939f7081f56b37dec686https://doi.org/10.5152/anatoljcardiol.2022.1122
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