Percutaneous coronary intervention for the ostial left circumflex coronary artery: comparison between crossover stenting and ostial stenting

Abstract

Background: Percutaneous coronary intervention for a lesion in the ostial left circumflex coronary artery (LCX) is challenging and the optimal stenting strategy remains unclear. We compared crossover stenting from the left main trunk (LMT) to the LCX with ostial stenting in the LCX. Methods: From October 2004 to May 2012, 61 lesions were successfully treated with drug-eluting stent: 39 lesions with LMT-LCX crossover stenting and 22 lesions with ostial LCX stenting. The follow-up angiography was performed at 8 months after procedure. Exclusion criteria included the following: bare metal stenting, hybrid stenting, in-stent restenosis at the ostial site of the LCX, trifurcation lesions, and previous LMT to left anterior descending coronary artery crossover stenting. The primary endpoints of our study were main and side branch restenoses and target lesion revascularization (TLR) at 8-month follow-up. Results: In LMT-LCX crossover stenting and ostial LCX stenting, the restenosis rates were 20.5% (8/39) and 40.1% (9/22) (p=0.008), the TLR rates were 12.8% (5/39) and 36.4% (8/22) (p=0.0031), and the clinically driven TLR rates were 7.7% (3/39) and 13.7% (3/22) (p=03458). ![Figure][1] Angiographical data Conclusion: The TLR rate was higher in ostial LCX stenting than in LMT-LCX crossover stenting. LMT-LCX crossover stenting may be more favorable if possible. [1]: pending:yes