Direct stent implantation without predilation using the multilink stent

The standard coronary stent implantation technique requires routine predila tation of the target lesion with a balloon catheter. In this study, we pros pectively studied the feasibility and efficiency of elective coronary stent implantation without predilatation. In 94 patients who presented with vari ous ischemic syndromes, direct implantation of 100 balloon expandable ACS M ultiLink stents (7 over-the-wire, 93 rapid exchange) was attempted in 100 c oronary lesions selected to have favorable characteristics. The stent cross ed the lesion without predilatation in 97 cases (97%) and was successfully deployed in 93 (95.8%). in 4 patients, adjunctive high-pressure postdilatat ion was necessary to achieve optimal stent expansion. Reference vessel diam eter was 3.12 +/- 0.77 mm and lesion length 8.8 +/- 2.7 mm. Minimal luminal diameter increased from 0.95 +/- 0.38 mm to 2.98 +/- 0.28 mm and diameter stenosis decreased from 71 +/- 11% to 8 +/- 11% after stenting. One occlusi ve dissection was treated by a second stent. There were no major in-hospita l complications. At 1 month follow-vp, 1 subacute thrombotic occlusion occu rred. These results indicate that in a carefully selected coronary lesion s ubset, elective stent implantation without predilatation can be safely and effectively performed. The long-term results of this approach and possible advantages over the conventional implantation techniques remain unclear and need to be evaluated in further clinical studies. (C) 1998 by Excerpta Med ico, Inc.