Ostial vs Left Main Crossover Stenting in Isolated Ostial Left Anterior Descending Stenosis: A Single-Center Retrospective Cohort Study
- 1Cardiovascular Institute, Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
Abstract
Background: Limited data exist on the optimal stenting strategy for isolated ostial left anterior descending coronary artery (LAD) lesions. The aim of this study was to compare the outcomes in patients who had a significant isolated ostial LAD stenosis treated with either left main crossover stenting (LMCS) or focal ostial LAD stenting (FO-LAD).
Methods: The primary end point of the study was target lesion failure (TLF), a composite of target lesion revascularization, target vessel myocardial infarction, and cardiac death at 2 years. Secondary end points included the individual components of the primary outcome. Additional secondary outcomes included major adverse cardiovascular events, which are a composite of all-cause mortality, myocardial infarction, cerebrovascular accident, and any unplanned revascularization.
Results: A total of 522 patients were included in this study, of whom 382 underwent FO-LAD stenting and 140 underwent LMCS. The primary outcome occurred in 32 patients (22.9%) in the LMCS and in 44 patients (11.5%) in the FO-LAD group at a median follow-up of 730 days (IQR, 451-730). LMCS was associated with a higher risk of TLF compared with FO-LAD stenting (adjusted HR, 1.86; 95% CI, 1.16-2.98; P = .01).
With regard to secondary outcomes, LMCS was associated with more major adverse cardiovascular events (31.4% vs 15.5%; adjusted HR, 2.11 [1.41-3.17]; P < .001) and cardiac death (17.1% vs 7.9%; adjusted HR, 2.05 [1.19-3.55]; P = .01]. No significant differences were observed for target lesion revascularization and target vessel myocardial infarction.
Conclusions: Left main crossover stenting was associated with a higher rate of TLF at a median follow-up of 2 years when compared with FO-LAD stenting in the treatment of patients with significant isolated ostial LAD disease.
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BibTeX
@article{camilleri2026ostial,
title = {{Ostial vs Left Main Crossover Stenting in Isolated Ostial Left Anterior Descending Stenosis: A Single-Center Retrospective Cohort Study}},
author = {William E Camilleri and Eleni Ntantou and Alexandr Valentijn Kloosterman and Joost Daemen and Jeroen Wilschut and Isabella Kardys and Rutger Jan Nuis and Roberto Diletti and Karim Mahmoud and Nicolas M Van Mieghem and Wijnand K Den Dekker},
journal = {Journal of the Society for Cardiovascular Angiography \& Interventions},
year = {2026},
month = aug,
doi = {10.1016/j.jscai.2026.105526},
url = {https://doi.org/10.1016/j.jscai.2026.105526},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Ostial vs Left Main Crossover Stenting in Isolated Ostial Left Anterior Descending Stenosis: A Single-Center Retrospective Cohort Study
AU - William E Camilleri
AU - Eleni Ntantou
AU - Alexandr Valentijn Kloosterman
AU - Joost Daemen
AU - Jeroen Wilschut
AU - Isabella Kardys
AU - Rutger Jan Nuis
AU - Roberto Diletti
AU - Karim Mahmoud
AU - Nicolas M Van Mieghem
AU - Wijnand K Den Dekker
PY - 2026
DA - 2026/08/04
JO - Journal of the Society for Cardiovascular Angiography & Interventions
DO - 10.1016/j.jscai.2026.105526
UR - https://doi.org/10.1016/j.jscai.2026.105526
AB - Background: Limited data exist on the optimal stenting strategy for isolated ostial left anterior descending coronary artery (LAD) lesions. The aim of this study was to compare the outcomes in patients who had a significant isolated ostial LAD stenosis treated with either left main crossover stenting (LMCS) or focal ostial LAD stenting (FO-LAD). Methods: The primary end point of the study was target lesion failure (TLF), a composite of target lesion revascularization, target vessel myocardial infarction, and cardiac death at 2 years. Secondary end points included the individual components of the primary outcome. Additional secondary outcomes included major adverse cardiovascular events, which are a composite of all-cause mortality, myocardial infarction, cerebrovascular accident, and any unplanned revascularization. Results: A total of 522 patients were included in this study, of whom 382 underwent FO-LAD stenting and 140 underwent LMCS. The primary outcome occurred in 32 patients (22.9%) in the LMCS and in 44 patients (11.5%) in the FO-LAD group at a median follow-up of 730 days (IQR, 451-730). LMCS was associated with a higher risk of TLF compared with FO-LAD stenting (adjusted HR, 1.86; 95% CI, 1.16-2.98; P = .01). With regard to secondary outcomes, LMCS was associated with more major adverse cardiovascular events (31.4% vs 15.5%; adjusted HR, 2.11 [1.41-3.17]; P < .001) and cardiac death (17.1% vs 7.9%; adjusted HR, 2.05 [1.19-3.55]; P = .01]. No significant differences were observed for target lesion revascularization and target vessel myocardial infarction. Conclusions: Left main crossover stenting was associated with a higher rate of TLF at a median follow-up of 2 years when compared with FO-LAD stenting in the treatment of patients with significant isolated ostial LAD disease.
SN - 2772-9303
ER -