Clinical outcomes of one-stent crossover approach for left main bifurcation in a single center

Year 2025, Volume: 16 Issue: 1, 106 - 112, 25.03.2025

Ufuk Yıldırım , Alperen Altınbaş

https://doi.org/10.18663/tjcl.1599187

Abstract

Aim: For the majority of left main coronary artery (LM) bifurcation lesions treated with percutaneous coronary intervention, one-stent crossover technique and provisional approach to the side branch is recommended, which is simpler compared to complex two-stent techniques. In this study, we aimed to reveal the clinical outcomes of one-stent crossover approach for LM bifurcation.
Material and Methods: Patients who underwent one-stent crossover technique for unprotected LM bifurcation lesion between May 2020 and November 2023 in our center were included in this retrospective observational study. Clinical and procedural characteristics of the patients were recorded. All patients or their relatives were called to inquire about clinical outcomes. The primary endpoint was determined as target lesion failure (TLF), which was defined as clinically driven target lesion revascularization (TLR), target lesion-related myocardial infarction (TL-MI), or sudden cardiac death (SCD).
Results: A total of 86 patients were included in the study. Crossover stenting was performed from the LM to the left anterior descending artery (LAD) in 76 patients and from the LM to the left circumflex artery (LCX) in 8 patients. The median follow-up time was 22 (3-54) months. Clinically driven TLR occurred in 2 patients, TL-MI in 1 patient, and SCD in 1 patient. TLF criteria were met in only 3 patients. Of these patients, 2 had undergone LM-LAD and 1 had undergone LM-LCX crossover stenting.
Conclusion: One-stent crossover approach for LM bifurcation lesions is associated with very good clinical outcomes.

Keywords

one-stent, crossover stenting, left main bifurcation

Sol ana koroner arter bifurkasyonu için tek stentli crossover yaklaşımın tek merkez klinik sonuçları

Abstract

Amaç: Perkütan koroner girişim ile tedavi edilen sol ana koroner arter (LM) bifurkasyon lezyonlarının çoğunda, kompleks çift stentleme tekniklerine kıyasla daha basit olan tek stentli crossover teknik ve yan dala provizyonel yaklaşım önerilmektedir. Bu çalışmada, LM bifurkasyonu için tek stentli crossover yaklaşımın klinik sonuçlarını ortaya koymayı amaçladık.
Gereç ve Yöntemler: Merkezimizde Mayıs 2020 ile Kasım 2023 tarihleri arasında, korumasız LM bifurkasyon lezyonuna tek stentli crossover teknik uygulanan hastalar retrospektif gözlemsel bu çalışmaya dahil edildi. Hastaların klinik ve prosedürel özellikleri kaydedildi. Tüm hastalar veya yakınları aranarak klinik sonuçlar sorgulandı. Birincil sonlanım noktası; kliniğe dayalı hedef lezyon revaskülarizasyonu (TLR), hedef lezyonla ilişkili miyokart enfarktüsü (TL-MI) veya ani kardiyak ölüm (SCD) olarak tanımlanan hedef lezyon başarısızlığı (TLF) olarak belirlendi.
Bulgular: Toplam 86 hasta çalışmaya dahil edildi. Bu hastaların 76'sında LM'den sol ön inen artere (LAD) doğru, 8'inde LM'den sol sirkumfleks artere (LCX) doğru crossover stentleme yapılmıştı. Ortanca takip süresi 22 (3-54) aydı. Hastaların 2'sinde kliniğe dayalı TLR, 1'inde TL-MI, 1'inde SCD gelişmişti. TLF kriterleri yalnızca 3 hastada gerçekleşmişti. Bu hastaların 2 tanesine LM-LAD, 1 tanesine LM-LCX crossover stentleme uygulanmıştı.
Sonuç: LM bifurkasyon lezyonları için tek stentli crossover yaklaşım oldukça iyi klinik sonuçlarla ilişkilidir.

Keywords

tek stent, crossover stentleme, sol ana koroner arter bifurkasyonu

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