• Impact of different final optimization techniques on long-term clinical outcomes of left main cross-over stenting



    The optimal final optimization technique to be used in patients after Cross Over Left main stenting remainsdebatable.


    We evaluate the impact of the post-optimization technique (POT), kissing balloon (KB) and the POT-side-POT techniques on both cardiovascular mortality and event-free survival in patients receiving left main (LM) cross-over stenting for an isolated/distal bifurcation LM disease.


    Clinical and instrumental records of 128 consecutive patients (102 males, mean age 73.39 ± 9.54 years old) with isolated distal/bifurcation LM disease and bypass surgery contraindications or refusal enrolled to receive LM cross-over stenting between the 1st January 2012 and the 1st January 2017 at two institutions: the Rovigo General Hospital (Rovigo, Italy) and the Alexandrovka Hospital University School of Medicine (Sofia, Bulgaria). Patients has been divided into three groups (POT, KB and POT-side-POT) according the optimal final optimization technique used while the 5-year cardiovascular mortality has been evaluated using the log-rank (Mantel-Cox) analysis.


    Baseline angiographic characteristics of the LM disease were mostly equivalent among the three groups. Over a global follow-up of 61.03 ± 0.92 months, the rates of target vessel revascularization, acute myocardial infarction, and stent thrombosis, were not different among groups. Patients treated with POT had a slightly better long-term survival.


    None of these optimization techniques appeared to have clearly better long-term outcomes after LM Cross-over stenting in our retrospective study. POT resulted in a slightly better survival compared to Pot-sid-POT and KB.



    • Single cross-over stent implantation is the preferred technique to treat left main (LM) distal/bifurcation disease
    • Post Optimization Technique (POT) alone and POT-side-POT techniques were equivalent to Kissing balloon in LM Cross-over stenting

    Author bio

    Cardiovascular Revascularization Medicine, 2019-02-01, Volume 20, Issue 2, Pages 108-112, Copyright © 2018 Elsevier Inc.



    Read the original article on Science Direct: Impact of different final optimization techniques on long-term clinical outcomes of left main cross-over stenting

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