Multicenter randomized comparison of direct vs. conventional stenting: the DIRECTO trial.
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.
Ballarino
Miguel A
MA
Servicio de Hemodinamia, Hospital Privado, Córdoba, Argentina. miguelballarino@arnet.com.ar
Moreyra
Eduardo
E
Damonte
Aníbal
A
Sampaolesi
Alberto
A
Woodfield
Scott
S
Pacheco
Guillermo
G
Caballero
Gustavo
G
Picabea
Eduardo
E
Baccaro
Jorge
J
Tapia
Luis
L
Lascano
Esteban Ruiz
ER
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