Simple Crossover Stenting for the Left Main Bifurcation Lesions in Patients with Acute Coronary Syndrome: A Case Series

Background: Coronary bifurcation lesions challenge percutaneous coronary interventions, especially in unprotected left main (LM) coronary artery disease due to significant myocardial risk. This study assesses the efficacy of simple crossover provisional stenting (PS) technique from the LM to the left anterior descending artery, supplemented by proximal optimization technique, in acute coronary syndrome (ACS) patients with distal LM bifurcation lesions.

Case Presentation: We detail eight ACS cases with true and non-true LM distal bifurcation lesions that were treated using PS, achieving post-procedure thrombolysis in myocardial infarction III flow and no major adverse cardiac events over six months (minimum follow-up). Post-procedure, all patients achieved thrombolysis in myocardial infarction (TIMI) III flow. During follow-up, which ranged from a minimum of six months to two years, no major adverse cardiac events (MACE) were observed. Each case demonstrated successful revascularization, highlighting the effectiveness of the PS technique in this patient population.

Conclusions: This method provides a simplified revascularization strategy with improved outcomes, meriting further investigation through large-scale, long-term studies to validate its efficacy.