[Direct Stenting without Predilation: a Single-Center Experience with 1,000 Lesions].
BACKGROUND
Direct stenting has been shown to save costs, procedural time, radiation, and contrast use. We analyze the results of direct stenting in daily practice.


METHODS
We retrospectively analyzed the interventions in the first 1,000 lesions that were treated with direct stenting at our center. Primary success, dissection, need for additional dilation, embolism, stent loss, and side branch occlusion were the variables assessed.


RESULTS
Direct stenting was attempted in 1,000 lesions in 784 patients (age 63 11 years, females 21%, diabetes 37%). Primary or rescue angioplasty was performed in 8%. One or more thrombi were found in 16%, bifurcation in 9%, calcification in 5%, angulation in 2.3%, and tortuosity in 3.2%. The reference diameter was 3.0 0.5 mm. The primary success rate was 93.1%. Failure of direct stenting (6.9%) was associated with the circumflex artery in 38%, calcification in 26%, angulation in 22%, and tortuosity in 31%. In 39 lesions, additional dilation with different balloons was required. Additional stenting was required for dissection in 40 lesions and secondary to incomplete coverage of the lesion in 27. Thrombus embolism occurred in 7 lesions, 6 of them with a previously visible thrombus and one in a vein graft. Stent embolisms occurred in 6 cases, 4 of which were retrieved. Four side branches became occluded, but 2 of them were recovered at the end of the procedure.


CONCLUSIONS
Direct stenting is a safe technique with low percentage of dissection, need for postdilation, thrombus embolism, and side br
Sección de Hemodinámica, Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
Iñigo
I
Lozano
Ramón
R
López-Palop
Eduardo
E
Pinar
Rocío
R
Cortés
Pilar
P
Carrillo
Daniel
D
Saura
Raúl
R
Rodríguez
Francisco
F
Picó
Mariano
M
Valdés
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003627:Data Interpretation, Statistical; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects