Direct stenting without predilatation. Experience in 300 lesions

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.