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

被引:1
|
作者
Soylu, Korhan [1 ]
Yildirim, Ufuk [1 ]
Nasifov, Muharrem [2 ]
Ucar, Hakan [3 ]
Tasbulak, Omer [4 ]
Allahverdiyev, Samir [3 ]
Goktekin, Omer [2 ]
机构
[1] Ondokuz Mayis Univ, Fac Med, Dept Cardiol, Samsun, Turkey
[2] Mem Bahcelievler Hosp, Dept Cardiol, Istanbul, Turkey
[3] Istanbul Aydin Univ, Fac Med, Dept Cardiol, VM Florya Med Pk Hosp, Istanbul, Turkey
[4] Univ Hlth Sci, Mehmet Akif Ersoy Thorac & Cardiovasc Surg Traini, Dept Cardiol, Istanbul, Turkey
来源
ANATOLIAN JOURNAL OF CARDIOLOGY | 2022年 / 26卷 / 11期
关键词
Medina; bifurcation; ostial; coronary; stenting; KISSING-BALLOON TECHNIQUE; CORONARY-ARTERY; ANGIOGRAPHIC PREDICTORS; ELUTING STENT; RESTENOSIS;
D O I
10.5152/AnatolJCardiol.2022.1122
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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% Cl: 1.225-16.582, P=.024) and application of the crossover stenting technique (odds ratio = 5.126; 95% Cl: 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 not appropriate to apply a single method to all patients with such lesions.
引用
收藏
页码:827 / 831
页数:5
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