Mohamed Selmen Aissa

Regional Hospital of Siliana, Tunisia

Title: Mid-Term Clinical Outcomes Of Simple Crossover Stenting From The Left Main To The Left Anterior Descending Coronary Artery

Biography

He is a University Hospital Assistant at the Faculty of Medicine of Tunis, specializing in interventional cardiology. He currently practices at both the Regional Hospital of Siliana and Charles Nicolle University Hospital, where he integrates advanced clinical care, academic teaching, and applied research. His professional focus centers on the management of acute coronary syndromes, structural heart interventions, and complex angioplasty procedures. Deeply committed to advancing cardiovascular care in Tunisia—particularly in underserved regions—he is dedicated to delivering modern, evidence-based cardiology that is both accessible and patient-centered. Alongside his clinical duties, he actively participates in the training of medical students and cardiology residents, fostering a rigorous, hands-on, and dynamic learning environment.

Abstract

Background: The stenosis of the left main coronary artery bifurcation is a complex lesion and it represents one of the challenges for the interventional cardiologist. Although simple strategy in left main (LM) bifurcation stenting was better than complex strategy in clinical outcomes, the fate of stent strut over ostial left circumflex coronary artery (LCx) after simple crossover stenting is not validated yet. We aimed to evaluate the immediate procedural and clinical success as well as the mid-term clinical outcomes after simple crossover stenting from the LM to the left anterior descending coronary artery (LAD). Methods: In this retrospective, observational study, patients who underwent successful LM-to LAD simple crossover stenting due to significant de novo LM or ostial LAD disease  in the absence of angiographically sig-nificant ostial LCX disease and  without additional SB procedure were consecutively enrolled. Procedure success, target lesion failure (TLF) and patient oriented composite outcome (POCO) were analyzed. Results: Among 42 patients who underwent the 1-stent strategy Between January 2017 and June 2021, 31 (73.8%) patients were treated with simple crossover alone, and 11 (26.2%) patients were treated with an additional LCx-opening procedure.  The immediate procedure success rate was 100%. The midterm observed TLF rate was similar between the 2 groups (13% in the crossover group and 9% in the LCx opening group, P = 0.607) as well as POCO rate (16.1% in the crossover group and 27% in the LCx opening group, P = 0.345). Conclusion: Simple crossover LM-to-LAD stenting without opening of a strut on the LCX ostium was associated with acceptable mid-term clinical outcomes. Routine LCx opening procedure after simple crossover stenting is not recommendable. However, this strategy should be confirmed with large randomized studies.