title: Long-term outcomes of simple crossover stenting from the left main to the left anterior descending coronary artery.
abstract: OBJECTIVE
  Although complex bifurcation stenting in patients with non-left main (LM) bifurcation lesions has not yielded better clinical outcomes than simpler procedures, the utility of complex bifurcation stenting to treat LM bifurcation lesions has not yet been adequately explored.
  
  
  METHODS
  In the present study, patients who underwent LM-to-left anterior descending (LAD) coronary artery simple crossover stenting to treat significant de novo distal LM or ostial LAD disease, in the absence of angiographically significant ostial left circumflex (LCX) coronary artery disease, were consecutively enrolled. The frequencies of 3-year major adverse cardiovascular events (MACEs; cardiac death, myocardial infarction, and target lesion revascularization), were analyzed.
  
  
  RESULTS
  Of 105 eligible consecutive patients, only 12 (11.4%) required additional procedures to treat ostial LCX disease after main vessel stenting. The mean percentage diameter of ostial LCX stenosis increased from 22.5% ± 15.2% to 32.3% ± 16.3% (p < 0.001) after LM-to-LAD simple crossover stenting. The 3-year incidence of MACEs was 9.7% (cardiac death 2.2%; myocardial infarction 2.2%; target lesion revascularization 8.6%), and that of stent thrombosis 1.1%. Of seven cases (7.5%) requiring restenosis, pure ostial LCX-related repeat revascularization was required by only two.
  
  
  CONCLUSIONS
  Simple crossover LM-to-LAD stenting without opening of a strut on the LCX ostium was associated with acceptable long-term clinical outcomes.
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Ho-Myung
authors.initials: HM
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Chang-Wook
authors.initials: CW
authors.lastname: Nam
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Yun-Kyeong
authors.initials: YK
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Hyuck-Jun
authors.initials: HJ
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Hyoung-Seob
authors.initials: HS
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Hyungseop
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Occupational and Environmental Medicine, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: In-Sung
authors.initials: IS
authors.lastname: Chung
authors.affiliation: Department of Biomedical Engineering, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Yun-Seok
authors.initials: YS
authors.lastname: Heo
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Hur
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Yoon-Nyun
authors.initials: YN
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Kwon-Bae
authors.initials: KB
authors.lastname: Kim
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000628:therapy*; D023903:Coronary Restenosis / Q000209:etiology; D023921:Coronary Stenosis / Q000628:therapy; D018572:Disease-Free Survival; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
keywords: Coronary stenosis; Outcome; Percutaneous coronary intervention; Stents