Direct stenting without predilatation: a new approach to coronary intervention.
BACKGROUND
Implantation of coronary stents after predilatation is a standard approach in the treatment of most coronary lesions. Stenting without predilatation 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 test the feasibility and safety of this new therapeutic concept.


METHODS
Ninety selected patients with 91 lesions were treated by implantation of coronary stents without predilatation.


RESULTS
The mean duration of this procedure was 12.3 +/- 9.1 min and the fluoroscopic time was 3.6 +/- 2.9 min. The stenoses before and after this procedure were 77 +/- 10 and 5 +/- 9%, respectively. Predilatation, postdilatation or implantation of an additional stent was necessary for seven patients. Primary success rate was 92% with an excellent immediate clinical and angiographic outcome. No major complications occurred during direct stenting.


CONCLUSIONS
Direct stenting is feasible using commercially available stents and could be performed for about 20% of patients for whom coronary intervention is indicated. The proper selection of lesions is of crucial importance. Lesions eligible for direct stenting should be without visible calcifications and on vessels without proximal tortuosity. This procedure proved to be safe and successful in this series of coronary interventions.
Veselka
J
J
Division of Cardiac Surgery, University Hospital Motol, Praha, Czech Republic. veselka.josef@usa.net
Mates
M
M
Tesar
D B
DB
Aschermann
M
M
Urbanová
T
T
Honek
T
T
D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D013997:Time Factors