Direct stenting without predilatation: a new approach to coronary intervention

Background Implantation of coronary stents after predilatation is a standar d approach in the treatment of most coronary lesions. Stenting without pred ilatation could be a possible alternative way of treating a certain subset of patients. Objective To identify a group of patients suitable for this optional method , to evaluate their immediate clinical and angiographic outcomes and to tes t the feasibility and safety of this new therapeutic concept, Methods Ninety selected patients with 91 lesions were treated by implantati on of coronary stents without predilatation, Results The mean duration of this procedure was 12.3 +/- 9.1 min and the fl uoroscopic time was 3.6 +/- 2.9 min. The stenoses before and after this pro cedure were 77 +/- 10 and 5 +/- 9%, respectively, Predilatation, postdilata tion or implantation of an additional stent was necessary for seven patient s, Primary success rate was 92% with an excellent immediate clinical and an giographic outcome, No major complications occurred during direct stenting. Conclusion Direct stenting is feasible using commercially available stents and could be performed for about 20% of patients for whom coronary interven tion is indicated, The proper selection of lesions is of crucial importance . Lesions eligible for direct stenting should be without visible calcificat ions and on vessels without proximal tortuosity, This procedure proved to b e safe and successful in this series of coronary interventions. Coron Arter y Dis 11:503-507 (C) 2000 Lippincott Williams & Wilkins.