ArticleHeart (British Cardiac Society)2023
Propensity-matched analysis of long-term clinical results after ostial circumflex revascularisation.
Article in Heart (British Cardiac Society), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 8 citations in OpenAlex.
- PCI for Ostial Stenosis of Left Circumflex or Left Anterior Descending Artery.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026Observational
- Article
- Case Report: Overcoming calcified nodules by repeated aggressive debulking and stent-free percunatenous coronary intervention using a drug-coated balloon.Frontiers in cardiovascular medicine · 2025Article
- The Role of Intravascular Ultrasound in the Evaluation and Treatment of Free-Floating Stent Struts Following Inadequate Ostial Circumflex Stenting: A Case Report.Medicina (Kaunas, Lithuania) · 2024Article
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Authors and funding
15 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPercutaneous coronary intervention (PCI) of the ostium of the left circumflex artery (LCx) is technically challenging. The aim of this study was to compare long-term clinical outcomes of ostial PCI located in the LCx versus the left anterior descending artery (LAD) in a propensity-matched population.
methodsConsecutive patients with a symptomatic isolated 'de novo' ostial lesion of the LCx or LAD treated with PCI were included. Patients with a stenosis of >40% in the left main (LM) were excluded. A propensity score matching was performed to compare both groups. The primary endpoint was target lesion revascularisation (TLR); other endpoints included target lesion failure and an analysis of the bifurcation angles.
resultsFrom 2004 to 2018, 287 consecutive patients with LAD (n=240) or LCx (n=47) ostial lesions treated with PCI were analysed. After the adjustment, 47 matched pairs were obtained. The mean age was 72±12 years and 82% were male. The LM-LAD angle was significantly wider than the LM-LCx angle (128°±23° vs 108°±24°, p=0.002). At a median follow-up of 5.5 (IQR 1.5-9.3) years, the rate of TLR was significantly higher in the LCx group (15% vs 2%); with an HR of 7.5, 95% CI 2.1 to 26.4, p<0.001. Interestingly, in the LCx group, TLR-LM occurred in 43% of the TLR cases; meanwhile, no TLR-LM involvement was found in the LAD group.
conclusionsIsolated ostial LCx PCI was associated with an increase in the rate of TLR compared with ostial LAD PCI at long-term follow-up. Larger studies evaluating the optimal percutaneous approach at this location are needed.
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