Clinical outcomes of one-stent crossover approach for left main bifurcation in a single center

Aim: For the majority of left main coronary artery (LM) bifurcation lesions treated with percutaneous coronary intervention, one-stent crossover technique and provisional approach to the side branch is recommended, which is simpler compared to complex two-stent techniques. In this study, we aimed to reveal the clinical outcomes of one-stent crossover approach for LM bifurcation. Material and Methods: Patients who underwent one-stent crossover technique for unprotected LM bifurcation lesion between May 2020 and November 2023 in our center were included in this retrospective observational study. Clinical and procedural characteristics of the patients were recorded. All patients or their relatives were called to inquire about clinical outcomes. The primary endpoint was determined as target lesion failure (TLF), which was defined as clinically driven target lesion revascularization (TLR), target lesion-related myocardial infarction (TL-MI), or sudden cardiac death (SCD). Results: A total of 86 patients were included in the study. Crossover stenting was performed from the LM to the left anterior descending artery (LAD) in 76 patients and from the LM to the left circumflex artery (LCX) in 8 patients. The median follow-up time was 22 (3-54) months. Clinically driven TLR occurred in 2 patients, TL-MI in 1 patient, and SCD in 1 patient. TLF criteria were met in only 3 patients. Of these patients, 2 had undergone LM-LAD and 1 had undergone LM-LCX crossover stenting. Conclusion: One-stent crossover approach for LM bifurcation lesions is associated with very good clinical outcomes.