Reassessing single-stent techniques for isolated left anterior descending ostial disease: a two-year intravascular ultrasound-guided retrospective comparison of precise ostial, floating, and crossover stenting strategies
Abstract Background/Objectives Percutaneous coronary intervention (PCI) for isolated left anterior descending (LAD) ostial lesions remains challenging, with limited comparative data on stenting strategies. We aimed to evaluate the procedural and long-term outcomes of three single-stent techniques: p...
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2025-06-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-025-04894-3 |
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| author | Xi Wu Mingxing Wu Haobo Huang Zhe Liu He Huang Lei Wang |
| author_facet | Xi Wu Mingxing Wu Haobo Huang Zhe Liu He Huang Lei Wang |
| author_sort | Xi Wu |
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| description | Abstract Background/Objectives Percutaneous coronary intervention (PCI) for isolated left anterior descending (LAD) ostial lesions remains challenging, with limited comparative data on stenting strategies. We aimed to evaluate the procedural and long-term outcomes of three single-stent techniques: precise ostial stenting (POS), floating stenting (FS), and crossover stenting (CS). Methods In this retrospective study, 116 patients with isolated LAD ostial disease underwent intravascular ultrasound (IVUS)-guided PCI using one of the three strategies. Baseline characteristics, procedural details, IVUS findings, and major adverse cardiac and cerebrovascular events (MACCEs) over two years were compared. Results Compared to POS and FS, CS resulted in larger minimal stent area at the ostium, and a higher rate of complete stent coverage (100% vs. 39.5% and 23.1%, p < 0.001). At 2-year follow-up, MACCE rates were significantly lower in the CS group (2.6%) compared to FS (13.5%) and POS (15.8%, p = 0.039), mainly due to reduced target lesion revascularization. FS showed improved coverage compared to POS, but inferior angiographic outcomes and higher event rates than CS. Conclusions In IVUS-guided PCI for isolated LAD ostial lesions, CS offers superior ostial coverage and clinical outcomes. FS may serve as a compromise when anatomical constraints limit crossover. These findings support a tailored strategy based on lesion characteristics and IVUS assessment. |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-06-01 |
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| series | BMC Cardiovascular Disorders |
| spelling | doaj-art-6b0f6f9b362e47ed81bc4c60da8a55a02025-08-20T03:25:15ZengBMCBMC Cardiovascular Disorders1471-22612025-06-0125111310.1186/s12872-025-04894-3Reassessing single-stent techniques for isolated left anterior descending ostial disease: a two-year intravascular ultrasound-guided retrospective comparison of precise ostial, floating, and crossover stenting strategiesXi Wu0Mingxing Wu1Haobo Huang2Zhe Liu3He Huang4Lei Wang5Department of Cardiology, Xiangtan Central Hospital (the affiliated hospital of Hunan University)Department of Cardiology, Xiangtan Central Hospital (the affiliated hospital of Hunan University)Department of Cardiology, Xiangtan Central Hospital (the affiliated hospital of Hunan University)Department of Cardiology, Xiangtan Central Hospital (the affiliated hospital of Hunan University)Department of Cardiology, Xiangtan Central Hospital (the affiliated hospital of Hunan University)Department of Cardiology, Xiangtan Central Hospital (the affiliated hospital of Hunan University)Abstract Background/Objectives Percutaneous coronary intervention (PCI) for isolated left anterior descending (LAD) ostial lesions remains challenging, with limited comparative data on stenting strategies. We aimed to evaluate the procedural and long-term outcomes of three single-stent techniques: precise ostial stenting (POS), floating stenting (FS), and crossover stenting (CS). Methods In this retrospective study, 116 patients with isolated LAD ostial disease underwent intravascular ultrasound (IVUS)-guided PCI using one of the three strategies. Baseline characteristics, procedural details, IVUS findings, and major adverse cardiac and cerebrovascular events (MACCEs) over two years were compared. Results Compared to POS and FS, CS resulted in larger minimal stent area at the ostium, and a higher rate of complete stent coverage (100% vs. 39.5% and 23.1%, p < 0.001). At 2-year follow-up, MACCE rates were significantly lower in the CS group (2.6%) compared to FS (13.5%) and POS (15.8%, p = 0.039), mainly due to reduced target lesion revascularization. FS showed improved coverage compared to POS, but inferior angiographic outcomes and higher event rates than CS. Conclusions In IVUS-guided PCI for isolated LAD ostial lesions, CS offers superior ostial coverage and clinical outcomes. FS may serve as a compromise when anatomical constraints limit crossover. These findings support a tailored strategy based on lesion characteristics and IVUS assessment.https://doi.org/10.1186/s12872-025-04894-3Ostial left anterior descending lesionPercutaneous coronary interventionFloating stentCrossover stentingIntravascular ultrasound |
| spellingShingle | Xi Wu Mingxing Wu Haobo Huang Zhe Liu He Huang Lei Wang Reassessing single-stent techniques for isolated left anterior descending ostial disease: a two-year intravascular ultrasound-guided retrospective comparison of precise ostial, floating, and crossover stenting strategies BMC Cardiovascular Disorders Ostial left anterior descending lesion Percutaneous coronary intervention Floating stent Crossover stenting Intravascular ultrasound |
| title | Reassessing single-stent techniques for isolated left anterior descending ostial disease: a two-year intravascular ultrasound-guided retrospective comparison of precise ostial, floating, and crossover stenting strategies |
| title_full | Reassessing single-stent techniques for isolated left anterior descending ostial disease: a two-year intravascular ultrasound-guided retrospective comparison of precise ostial, floating, and crossover stenting strategies |
| title_fullStr | Reassessing single-stent techniques for isolated left anterior descending ostial disease: a two-year intravascular ultrasound-guided retrospective comparison of precise ostial, floating, and crossover stenting strategies |
| title_full_unstemmed | Reassessing single-stent techniques for isolated left anterior descending ostial disease: a two-year intravascular ultrasound-guided retrospective comparison of precise ostial, floating, and crossover stenting strategies |
| title_short | Reassessing single-stent techniques for isolated left anterior descending ostial disease: a two-year intravascular ultrasound-guided retrospective comparison of precise ostial, floating, and crossover stenting strategies |
| title_sort | reassessing single stent techniques for isolated left anterior descending ostial disease a two year intravascular ultrasound guided retrospective comparison of precise ostial floating and crossover stenting strategies |
| topic | Ostial left anterior descending lesion Percutaneous coronary intervention Floating stent Crossover stenting Intravascular ultrasound |
| url | https://doi.org/10.1186/s12872-025-04894-3 |
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