Introduction. The stent alone technique, direct stenting without predilatat
ion, aims to reduce cost and procedural time. Other potential benefits are
the avoidance of abrupt vessel closure after balloon angioplasty and lessen
ing of the restenosis rate due to the reduced arterial injury. We present o
ur experience with this therapeutic approach in a long series of patients.
Patients and methods. 230 patients referred to our unit were included with
300 non-occlusive stenotic lesions without excessive tortuosity, calcificat
ion, length or angulation and with a reference vessel diameter greater than
or equal to 2,5 mm. In these patients stent implantation without predilata
tion was attempted. The inmediate angiographic results and procedural relat
ed complications were evaluated.
Results. The stent alone technique succeeded in 256 (85%) among the 300 les
ions treated. In 43 (14,3%) lesions predilatation was required and in one c
ase the stent could not be positioned. A new dilatation after deployment wa
s required due to suboptimal stent expansion in 27/256 (10,5%) lesions. Ste
nt embolization occurred in 5 patients, 4 stents were retrieved and there w
ere no clinical sequelae. The best results were obtained in non-subtotal an
d non-bifurcated lesions type A or B1 without moderate calcification, tortu
osity or angulation.
Conclusions. Direct stenting is feasible in a large number of patients with
a high success rate after an appropriate selection. The most optimal lesio
ns to be treated with this technique are less than or equal to 90% stenotic
non-bifurcated lesions type A or B1 without moderate calcification, tortuo
sity or angulation.