Direct coronary stenting without predilation

Citation
C. Briguori et al., Direct coronary stenting without predilation, J AM COL C, 34(7), 1999, pp. 1910-1915
Citations number
16
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
ISSN journal
07351097 → ACNP
Volume
34
Issue
7
Year of publication
1999
Pages
1910 - 1915
Database
ISI
SICI code
0735-1097(199912)34:7<1910:DCSWP>2.0.ZU;2-W
Abstract
OBJECTIVES Coronary stenting is the primary therapeutic option for percutan eous treatment of many coronary lesions, after the risk of subacute stent t hrombosis and bleeding complications has been reduced by improved antithrom botic regimens and high pressure stent expansion. BACKGROUND Direct stent implantation (without predilation) has been conside red a promising new technique that may reduce the procedure time, radiation exposure time and cost. METHODS After having reviewed all cases of stent implantation from February to June 1998 (n = 585), 185 (32%) of these patients were retrospectively c onsidered candidates for direct stent implantation without predilation, acc ording to prespecified criteria (i.e., absence of severe coronary calcifica tions and/or tortuosity of the lesion or the segment proximal to the lesion ). By operator preference, direct coronary stent implantation was actually attempted in 123 (21%) of the 585 patients (100 men, 60 +/- 10 years old) o n 123 lesions. The impact of direct stenting in terms of cost, procedure ti me, radiation exposure time and amount of contrast dye used was assessed by comparing the two groups of patients who underwent single-vessel stenting without (n = 69) and with (n = 46) predilation. RESULTS Direct stenting was successful in 118 patients (96%). No acute or s ubacute complications occurred in these patients. Procedure time, radiation exposure time and cost were significantly lower in the group of patients w ho had single-vessel direct versus conventional stenting (45 +/- 31 vs. 64 +/- 46 min, 12 +/- 9 vs. 16 +/- 10 min and 1,305 +/- 363 vs. 2,210 +/- 803 Euro, respectively; p < 0.05 for all). CONCLUSIONS Direct stenting without predilation in selected lesions seems t o be a safe and successful procedure that provides a way to contain cost an d to shorten radiation exposure time. (C) 1999 by the American College of C ardiology.