title: Direct coronary stenting without balloon predilation of lesions requiring long stents: immediate and 6-month results of a multicenter prospective registry.
abstract: To assess the outcomes of direct coronary stenting (DS) using long stents and examine predictive factors of DS failure, this prospective multicenter registry included 128 consecutive patients who underwent the implantation of stents >or= 18 mm in length without balloon predilation for de novo coronary artery stenoses. Mean lesion and stent lengths were 20.7 +/- 5.4 and 21.4 +/- 3.8 mm, respectively. Rates of DS success, lesion success, and primary success were 82%, 99%, and 97.7%, respectively. At 6 months, rates of MACE and TVR were 12.5% and 6.3%, respectively. In multivariate analysis, factors predictive of DS failure vs. DS success were presence of calcifications (78% vs. 45%; P = 0.004) and reference vessel diameter (2.77 +/- 0.4 vs. 3.13 +/- 0.42 mm; P = 0.0002). DS of complex lesions with stents >or= 18 mm in length was performed safely and with a high success rate. This strategy was less successful in the treatment of small vessels and in presence of calcifications.
authors.affiliation: Department of Cardiology, University Hospital of Rennes, Rennes, France. dominique.boulmier@chu-rennes.fr
authors.forename: Dominique
authors.initials: D
authors.lastname: Boulmier
authors.forename: Marc
authors.initials: M
authors.lastname: Bedossa
authors.forename: Philippe
authors.initials: P
authors.lastname: Commeau
authors.forename: Bruno
authors.initials: B
authors.lastname: Huret
authors.forename: Martine
authors.initials: M
authors.lastname: Gilard
authors.forename: Jacques
authors.initials: J
authors.lastname: Boschat
authors.forename: Philippe
authors.initials: P
authors.lastname: Brunel
authors.forename: Bernard
authors.initials: B
authors.lastname: Leurent
authors.forename: Hervé
authors.initials: H
authors.lastname: Le Breton
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000706:statistics & numerical data*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000706:statistics & numerical data*; D017023:Coronary Angiography / Q000706:statistics & numerical data; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011475:Prosthesis Failure; D012042:Registries / Q000706:statistics & numerical data*; D015607:Stents / Q000009:adverse effects* / Q000706:statistics & numerical data*; D013997:Time Factors