title: Multicenter randomized comparison of direct vs. conventional stenting: the DIRECTO trial.
abstract: With conventional stenting, predilatation frequently induces dissections that require deploying stents longer than originally planned. To assess whether direct stenting is safe and may prevent dissections and reduce the length of stents implanted, we conducted a randomized study comparing direct (n = 73) and conventional (n = 78) stenting. Direct stenting was successful in 89% of cases, 11% crossed over to predilation without complications. Dissections occurred more frequently in conventional stenting group (10.3% vs. 1.4%; P = 0.034), but did not translate to a significant stent length difference (16.31 +/- 7.6 vs. 15.31 +/- 5.5; P = NS). Periprocedure creatine kinase elevation and number of balloons utilized were lower with direct stenting.
authors.affiliation: Servicio de Hemodinamia, Hospital Privado, Córdoba, Argentina. miguelballarino@arnet.com.ar
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Ballarino
authors.forename: Eduardo
authors.initials: E
authors.lastname: Moreyra
authors.forename: Aníbal
authors.initials: A
authors.lastname: Damonte
authors.forename: Alberto
authors.initials: A
authors.lastname: Sampaolesi
authors.forename: Scott
authors.initials: S
authors.lastname: Woodfield
authors.forename: Guillermo
authors.initials: G
authors.lastname: Pacheco
authors.forename: Gustavo
authors.initials: G
authors.lastname: Caballero
authors.forename: Eduardo
authors.initials: E
authors.lastname: Picabea
authors.forename: Jorge
authors.initials: J
authors.lastname: Baccaro
authors.forename: Luis
authors.initials: L
authors.lastname: Tapia
authors.forename: Esteban Ruiz
authors.initials: ER
authors.lastname: Lascano
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods*; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D016001:Confidence Intervals; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D023903:Coronary Restenosis / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency