Crossover vs Accurate Ostial PCI for Medina 0.0.1 and 0.1.0 Left Main Bifurcation Lesions

Summary

Coronary artery disease is a leading cause of mortality and morbidity globally. The left coronary artery system is critically important due to its supply of a large area of myocardium. Ostia lesions of left anterior descending artery \[LAD\] and circumflex artery \[CX\]) present technical challenges during percutaneous coronary intervention (PCI) and are considered high-risk lesions due to their anatomical location, relationship with the left main coronary artery bifurcation. Two main approaches exist for treating these lesions: accurate ostial stenting and crossover stenting extending from the left main coronary artery to the relevant branch. Accurate ostial stenting aims to avoid unnecessary stenting of the left main coronary artery, while crossover stenting is more advantageous in terms of ensuring complete coverage of the ostial region. However, the crossover approach may have disadvantages such as larger stent implantation and potential side branch involvement. The current literature does not clearly define the clinical superiority of these two strategies. While various studies have shown no significant difference in mortality, myocardial infarction, and target lesion revascularization, the results are heterogeneous, and a definitive consensus has not been reached. The majority of current data are based on retrospective or observational studies. Therefore, well-designed prospective studies comparing crossover stenting and accurate ostial stenting strategies in the ostial left-sided coronary artery (LAD and CX) lesions are needed. This planned study aims to contribute to this gap in the literature by comparing the clinical outcomes of the two approaches.

Conditions

• Coronary Bifurcation Lesion
• Coronary Artery Disease (CAD)
• Left Main Coronary Artery Stenosis

Sponsors & Collaborators

• Yalova training and research hospital

  collaborator UNKNOWN

• Mersin City Hospital

  collaborator UNKNOWN

• Van Training and Research Hospital

  collaborator OTHER_GOV

• Başakşehir Çam & Sakura City Hospital

  collaborator OTHER_GOV

• Bakirkoy Dr. Sadi Konuk Research and Training Hospital

  collaborator OTHER_GOV

• Trakya University

  collaborator OTHER

• Sisli Hamidiye Etfal Training and Research Hospital

  collaborator OTHER

• Istanbul Training and Research Hospital

  collaborator OTHER_GOV

• Medipol University

  collaborator OTHER

• Samsun Education and Research Hospital

  collaborator OTHER

• Kocaeli University

  collaborator OTHER

• Abant Izzet Baysal University

  collaborator OTHER

• Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital

  collaborator OTHER

• Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital

  collaborator OTHER

• Bagcilar Training and Research Hospital

  collaborator OTHER_GOV

• Ankara City Hospital Bilkent

  collaborator OTHER

• Dicle University

  collaborator OTHER

• Bursa Yuksek Ihtisas Training and Research Hospital

  collaborator OTHER_GOV

• Haseki Training and Research Hospital

  collaborator OTHER

• Ahi Evran University Education and Research Hospital

  collaborator OTHER

• Ankara Etlik City Hospital

  collaborator OTHER_GOV

• Izmir Bakircay University

  collaborator OTHER

• Istanbul Medipol University Hospital

  collaborator OTHER

• Kutahya City Hospital

  collaborator OTHER

• Adiyaman University Research Hospital

  collaborator OTHER

• Adana City Training and Research Hospital

  collaborator OTHER

• Kosuyolu Heart Hospital

  collaborator OTHER

• Ege University

  collaborator OTHER

• Bursa City Hospital

  collaborator OTHER_GOV

• Bilecik Seyh Edebali Universitesi

  collaborator OTHER

• Siirt Training and Research Hospital

  collaborator OTHER_GOV

• Hitit University

  collaborator OTHER

• Istanbul Mehmet Akif Ersoy Educational and Training Hospital

  lead OTHER_GOV

Eligibility

Min Age

18 Years

Max Age

85 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-05-12

Primary Completion

2027-06-01

Completion

2027-06-15

Countries

• Turkey (Türkiye)

Study Locations