Long-term clinical follow-up after successful direct coronary stenting without predilatation.
BACKGROUND
Direct stent implantation without predilatation is considered a promising new technique that may reduce procedural time, radiation exposure, ischemic time and cost, but little information is available concerning the long-term outcome. The aim of this study was to investigate the long-term clinical outcome of successful direct stenting without predilatation.


METHODS
We prospectively undertook a clinical follow-up program (minimum 8 months) in a consecutive series of 101 patients (113 lesions) who were successfully treated with direct stenting without predilatation.


RESULTS
Clinical follow-up was obtained in all 101 patients at a mean period of 12.8 months (range 8 to 18.9). Stress test results were available in 94 patients (94%). During the follow-up period, 23 patients (23%) had one or more events, which included death in 2 patients (2%), target vessel revascularization in 14 (14%), myocardial infarction in 1 (1%) and positive stress test results or recurrence of symptoms (Canadian Cardiovascular Society I to II) treated medically in 6 (6%). Cumulative event-free survival at 8 and 18 months were 80% and 72%, respectively. Long-term clinical event rate was not significantly different among the clinical presentations, lesion types, or stent types. Angiographic follow-up was performed in 43 (43%) patients with 45 lesions. Restenosis (defined as 50% diameter stenosis) was observed in 14 of the lesions (31%).


CONCLUSIONS
Direct stenting without predilatation is an effective method of coronary intervention in terms of low long-term clinical event rate.
Chiou
Kuan-Rau
KR
Division of Cardiology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
Mar
Guang-Yuan
GY
Liang
Hsin-Li
HL
Tseng
Chi-Jen
CJ
Wu
Cheng-Ju
CJ
Hsieh
Pu-Lin
PL
Chiang
Hung-Ting
HT
Liu
Chun-Peng
CP
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents