Comparing cross-over stenting and focal ostial stenting for ostial left anterior descending coronary artery lesions: a systematic review and meta-analysis
Abstract Background The ideal revascularization approach for ostial left anterior descending coronary artery (L.A.D.) lesions continues to be a matter of debate. Two primary stenting strategies are often contemplated for managing these lesions: focal ostial stenting (F.O.S.) and the provisional stra...
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BMC
2025-02-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-024-04393-x |
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| author | Ahmed M. Khairy Abdelrahman H. Hafez Ahmed Elshahat Ahmed Emara Hadeel Aboueisha Mohamed Ismael Fahmy Ahmed Abdelaziz Ibrahim Yasseen |
| author_facet | Ahmed M. Khairy Abdelrahman H. Hafez Ahmed Elshahat Ahmed Emara Hadeel Aboueisha Mohamed Ismael Fahmy Ahmed Abdelaziz Ibrahim Yasseen |
| author_sort | Ahmed M. Khairy |
| collection | DOAJ |
| description | Abstract Background The ideal revascularization approach for ostial left anterior descending coronary artery (L.A.D.) lesions continues to be a matter of debate. Two primary stenting strategies are often contemplated for managing these lesions: focal ostial stenting (F.O.S.) and the provisional strategy, alternatively termed cross-over stenting (C.O.S.) from the LM to the L.A.D. artery. Aim Our objective is to assess the efficacy of C.O.S. vs. F.O.S. techniques in patients with ostial L.A.D. lesions who underwent percutaneous coronary intervention (P.C.I.). Methods We systematically searched five electronic databases to identify relevant studies. The data was pooled as odds ratio (O.R.) with its 95% confidence interval (C.I.) using the DerSimonian-Laird random effect model in STATA 17 MP. Significance was determined by a p-value > 0.05 between intervention subgroups. Results Nine articles with a total of 1492 patients were included in the meta-analysis. The pooled O.R. for Major Adverse Cardiovascular Events (MACE) was 0.88 (95% C.I. [0.39, 1.99], P = 0.76), indicating comparable rates between F.O.S. and C.O.S. For all-cause death, the O.R. was 1.46 (95% C.I. [0.53, 4.02], P = 0.46), with no significant differences between the compared techniques. Cardiovascular death showed no preference between treatments (O.R.=0.99, 95% C.I. [0.30, 3.31], P = 0.99), and similarly for myocardial infarction (O.R.=0.74, 95% C.I. [0.38, 1.44], P = 0.37). Conclusion Our meta-analysis comparing C.O.S. and F.O.S. for L.A.D. lesions revealed similar efficacy in clinical and angiographic outcomes. |
| format | Article |
| id | doaj-art-18162b62fb76405ab6b3fc4fd33fcb96 |
| institution | DOAJ |
| issn | 1471-2261 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj-art-18162b62fb76405ab6b3fc4fd33fcb962025-08-20T02:59:35ZengBMCBMC Cardiovascular Disorders1471-22612025-02-0125111510.1186/s12872-024-04393-xComparing cross-over stenting and focal ostial stenting for ostial left anterior descending coronary artery lesions: a systematic review and meta-analysisAhmed M. Khairy0Abdelrahman H. Hafez1Ahmed Elshahat2Ahmed Emara3Hadeel Aboueisha4Mohamed Ismael Fahmy5Ahmed Abdelaziz6Ibrahim Yasseen7Cardiology Department, Faculty of Medicine, Al-Azhar UniversityCardiology Department, Faculty of Medicine, Al-Azhar UniversityMedical Research Group of Egypt (MRGE)Medical Research Group of Egypt (MRGE)Medical Research Group of Egypt (MRGE)Medical Research Group of Egypt (MRGE)Medical Research Group of Egypt (MRGE)Cardiology Department, Faculty of Medicine, Al-Azhar UniversityAbstract Background The ideal revascularization approach for ostial left anterior descending coronary artery (L.A.D.) lesions continues to be a matter of debate. Two primary stenting strategies are often contemplated for managing these lesions: focal ostial stenting (F.O.S.) and the provisional strategy, alternatively termed cross-over stenting (C.O.S.) from the LM to the L.A.D. artery. Aim Our objective is to assess the efficacy of C.O.S. vs. F.O.S. techniques in patients with ostial L.A.D. lesions who underwent percutaneous coronary intervention (P.C.I.). Methods We systematically searched five electronic databases to identify relevant studies. The data was pooled as odds ratio (O.R.) with its 95% confidence interval (C.I.) using the DerSimonian-Laird random effect model in STATA 17 MP. Significance was determined by a p-value > 0.05 between intervention subgroups. Results Nine articles with a total of 1492 patients were included in the meta-analysis. The pooled O.R. for Major Adverse Cardiovascular Events (MACE) was 0.88 (95% C.I. [0.39, 1.99], P = 0.76), indicating comparable rates between F.O.S. and C.O.S. For all-cause death, the O.R. was 1.46 (95% C.I. [0.53, 4.02], P = 0.46), with no significant differences between the compared techniques. Cardiovascular death showed no preference between treatments (O.R.=0.99, 95% C.I. [0.30, 3.31], P = 0.99), and similarly for myocardial infarction (O.R.=0.74, 95% C.I. [0.38, 1.44], P = 0.37). Conclusion Our meta-analysis comparing C.O.S. and F.O.S. for L.A.D. lesions revealed similar efficacy in clinical and angiographic outcomes.https://doi.org/10.1186/s12872-024-04393-xOstial L.A.D.C.O.SF.O.SComplex lesionsCrossoverP.C.I |
| spellingShingle | Ahmed M. Khairy Abdelrahman H. Hafez Ahmed Elshahat Ahmed Emara Hadeel Aboueisha Mohamed Ismael Fahmy Ahmed Abdelaziz Ibrahim Yasseen Comparing cross-over stenting and focal ostial stenting for ostial left anterior descending coronary artery lesions: a systematic review and meta-analysis BMC Cardiovascular Disorders Ostial L.A.D. C.O.S F.O.S Complex lesions Crossover P.C.I |
| title | Comparing cross-over stenting and focal ostial stenting for ostial left anterior descending coronary artery lesions: a systematic review and meta-analysis |
| title_full | Comparing cross-over stenting and focal ostial stenting for ostial left anterior descending coronary artery lesions: a systematic review and meta-analysis |
| title_fullStr | Comparing cross-over stenting and focal ostial stenting for ostial left anterior descending coronary artery lesions: a systematic review and meta-analysis |
| title_full_unstemmed | Comparing cross-over stenting and focal ostial stenting for ostial left anterior descending coronary artery lesions: a systematic review and meta-analysis |
| title_short | Comparing cross-over stenting and focal ostial stenting for ostial left anterior descending coronary artery lesions: a systematic review and meta-analysis |
| title_sort | comparing cross over stenting and focal ostial stenting for ostial left anterior descending coronary artery lesions a systematic review and meta analysis |
| topic | Ostial L.A.D. C.O.S F.O.S Complex lesions Crossover P.C.I |
| url | https://doi.org/10.1186/s12872-024-04393-x |
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