Routine stenting in all vessels larger than 2.5 mm? Arguments in favour

Coronary stenting has provided better results than balloon angioplasty in t erms of primary success and restenosis in previous randomized studies. Thes e studies only included short coronary lesions located in vessels larger th an 3 mm. Thus, these results can not be applied to complex lesions or those located in small vessels. In the present article we summarize our points o f view regarding the current indications of coronary stenting in these type s of lesions, where the use of this device may be still controversial. In a ll these situations the results of the stent seem to be better to those pre viously reported with balloon angioplasty. However, there is a percentage o f patients treated by balloon angioplasty in whom a good immediate and long -term result can be obtained. The identification of patients with optimal r esult after balloon angioplasty need a postprocedure study of coronary flow reserve. The comparison of optimal baboon angioplasty (by angiographic and coronary flow reserve criteria) and stent, is the main objective of 2 stud ies that are currently under process. We will have to wait the results of t hese clinical trials to answer to the question if the implant of stents in all kind of lesions located in vessel larger than 2.5 mm is of proper use. Our current opinion is that coronary stenting is a safe and fast method of coronary transcatheter therapy in many types of coronary lesions and it mag be considered the more efficient technique of percutaneous revascularizati on.