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ȣ - 550704 195 |
Is it Safe that Left Main Crossover Stenting without Opening of Left Circumflex Coronary Artery? |
계명대학교 동산병원 심장내과 |
이호명, 남창욱,배한준,최상웅, 신홍원, 조현옥, 조윤경, 박형섭, 윤혁준, 김형섭, 허승호, 김윤년, 김권배 |
Background: Simple crossover stenting in non-left main (LM) bifurcation lesion without opening of stent strut in the ostium of side branch demonstrated a favorable outcome. However the safety and efficacy of the same strategy for LM crossover stenting has not been validated yet.
Methods:
The patients who had a LM or ostial LAD disease and planned LM to left anterior descending coronary artery (LAD) crossover stenting with single drug-eluting stent were recruited. The 3-year outcomes in patients with non-significant residual stenosis (<70%) in ostial LCX after stenting were evaluated. The major adverse cardiac events were defined as the composite of cardiac death,, myocardial infarction (MI), repeat revascularization, and stent thrombosis (ST).
Results:
: Among the included 110 patients, 98 (87.5%) patients were deferred without any additional procedure in ostial LCX. Preinterventional and post-stent % diameter stenosis of ostial LCX were 21.9±14.6% and 31.6±16.1%, respectively (p<0.001). The rate of 3-year MACE was 8.2%; cardiac death 3.1%, MI 2.0%, repeat revascularization 6.1%, and ST 1 %, respectively. Pure ostial LCX related MACE was 4.1%. Event free survival curve was presented in figure
Conclusions:
: Although the ostial strut of LCX was not opened after LM crossover stenting, the clinical outcome of this strategy demonstrated safe and favorable long-term clinical outcomes.
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