[A direct stent without predilatation. Our experience in 300 lesions].
BACKGROUND
The stent alone technique, direct stenting without predilatation, aims to reduce cost and procedural time. Other potential benefits are the avoidance of abrupt vessel closure after balloon angioplasty and lessening of the restenosis rate due to the reduced arterial injury. We present our experience with this therapeutic approach in a long series of patients.


METHODS
230 patients referred to our unit were included with 300 non-occlusive stenotic lesions without excessive tortuosity, calcification, length or angulation and with a reference vessel diameter > or = 2.5 mm. In these patients stent implantation without predilatation was attempted. The immediate angiographic results and procedural related complications were evaluated.


RESULTS
The stent alone technique succeeded in 256 (85%) among the 300 lesions treated. In 43 (14.3%) lesions predilatation was required and in one case the stent could not be positioned. A new dilatation after deployment was required due to suboptimal stent expansion in 27/256 (10.5%) lesions. Stent embolization occurred in 5 patients, 4 stents were retrieved and there were no clinical sequelae. The best results were obtained in non-subtotal and non-bifurcated lesions type A or B1 without moderate calcification, tortuosity 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 lesions to be treated with this technique are < or = 90% stenotic non-bifurcated lesions type A or B1 without moderate calcification, tortuosity or angulation.
de la Torre Hernández
J M
JM
Unidad de Hemodinámica y Cardiología Intervencionista, Hospital Universitario Marqués de Valdecilla, Santander.
Riesco Riesco
J F
JF
Rodríguez Entem
F
F
Figueroa Olabarría
A
A
Zueco Gil
J
J
Colman
T
T
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy*; D011379:Prognosis; D015607:Stents; D016896:Treatment Outcome
Stent directo sin predilatación. Experiencia en 300 lesiones.