Vol. 7, Issue 2, Part A (2025)

Background: Controversial outcomes are present in the current literature on isolated ostial Left Anterior Descending artery (LAD) disease. The aim of this investigation was to investigate the clinical outcomes of patients who presented with acute coronary syndrome and an ostial LAD significant lesion treated with crossover stenting and the others were treated with precise ostial stenting.

Methods: This observational investigation was conducted on 68 patients, both male and female, with acute coronary syndrome and underwent percutaneous coronary intervention (PCI). The culprit lesion was an isolated ostial LAD lesion. Patients were further subdivided into two groups: Group 1 (Ostial stenting) (n = 41): Precise ostial LAD stenting and Group 2 (Cross-over stenting) (n = 27): LM-LAD cross over stenting.

Results: There was significant difference between the two groups regarding stent length, Major Adverse Cardiovascular Events (MACE), maximum stent post dilatation, kissing balloon inflation (KBI) and type of intervention (P value <0.05). Univariate and multivariate analysis were performed to investigate the possible predictive factors for MACE. In univariate analysis: crossover stenting and performing KBI were associated with lower incidence of MACE, but multivariate analysis showed none of both can independently predict incidence of MACE.

Conclusions: Patient with significant isolated ostial LAD lesion treated with PCI using precise ostial stenting had higher incidence of MACE compared to LM - LAD crossover stenting, so in term of both safety and efficacy, 6-month clinical outcomes of PCI to isolated ostial LAD stated that the crossover stenting might be reasonable and safe option in treating ostial LAD lesions.