Optimal minimal stent area after crossover stenting in patients with unprotected left main coronary artery disease
Authors' conclusion
Achieving sufficient stent expansion in the proximal LM and preventing underexpansion in both the distal LM and LAD ostium are critical for improving long-term clinical outcomes. The identified MSA thresholds may serve as practical benchmarks for stent optimisation during LM PCI.
Study context
- Population
- Patients who underwent intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) for unprotected LM disease using a single-stent crossover technique
- Participants
- 829 consecutive patients
- Comparison
- Stent underexpansion vs adequate expansion by IVUS-measured segmental minimal stent area (MSA) after LM crossover stenting
- Outcome
- MACE, including all-cause death, myocardial infarction, and target lesion revascularisation
- Follow-up
- 5-year
Methodological detailsconsecutive patients, IVUS-guided PCI, single-stent crossover technique
- Consecutive patients
- IVUS-guided PCI
- Single-stent crossover technique
Main finding
As reported in the abstract
Adjusted hazard ratio
2.34
P < 0.001
Stent underexpansion in the proximal LM · increased risk of 5-year major adverse cardiac events (MACE)
Adjusted hazard ratio
2.57
P < 0.001
Simultaneous stent underexpansion in both the distal LM and LAD ostium · higher risk of 5-year MACE
Further findings
MSA cutoff values best predicting 5-year MACE
Mm²
- Proximal LM cutoff (AUC 0.62)
- 11.4
- Distal LM cutoff (AUC 0.58)
- 8.4
- LAD ostium cutoff (AUC 0.57)
- 8.1
Original publication
Optimal minimal stent area after crossover stenting in patients with unprotected left main coronary artery disease. EuroIntervention. Published 15 September 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →