title: New approach to direct stenting using a novel "all-in-one" coronary stent system via 5 French diagnostic catheters: a pilot study.
abstract: OBJECTIVE
  We sought to evaluate the strategy success and short term clinical outcomes of direct stenting via 5 French (F) diagnostic catheters using a novel bare metal stent with integrated delivery system (IDS) (Svelte Medical Systems, New Providence, NJ) and compare the results to a conventionally treated matched group.
  
  
  METHODS
  Fifteen consecutive patients with lesions deemed suitable for direct stenting using a bare metal stent were included. The primary endpoint was the strategy success defined as the ability to successfully treat a target lesion via a 5 F diagnostic catheter with a good angiographic result (TIMI III flow, residual stenosis ≤20%). Procedure and fluoroscopy times, contrast agent use, cost, and short-term clinical outcomes were compared to a matched group treated via conventional stenting.
  
  
  RESULTS
  The primary endpoint was reached in 14/15 patients (93%). There were no significant differences in procedural (58.6 min ± 12.7 vs. 57.4 min ± 14.2) or fluoroscopy times (10.0 min ± 4.3 vs.10.1 min ± 3.9) or contrast agent use (193.7 ml ± 54.8 vs. 181.4 ml ± 35.6). However, there were significant reductions in materials used in the study group compared to the control group equating to cost savings of almost US $600 per case (US $212.44 ± 258.09 vs. US $804.69 ± 468.11; P = 0.001).
  
  
  CONCLUSIONS
  Direct stenting using a novel bare metal stent with an IDS via 5 F diagnostic catheters is a viable alternative to conventional stenting in selected patients and is associated with significant cost savings.
authors: Department of Cardiology, Bern University Hospital, Bern, Switzerland.
authors: Ahmed A
authors: AA
authors: Khattab
authors: Crochan J
authors: CJ
authors: O'Sullivan
authors: Giulio G
authors: GG
authors: Stefanini
authors: Lorenz
authors: L
authors: Räber
authors: Mark
authors: M
authors: Paquin
authors: Stephan
authors: S
authors: Windecker
authors: Bernhard
authors: B
authors: Meier
mesh_terms: D000368:Aged; D062906:Cardiac Catheters / Q000191:economics; D016022:Case-Control Studies; D003287:Contrast Media; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D004867:Equipment Design; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation*; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011474:Prosthesis Design; D015641:Radiography, Interventional; D015607:Stents / Q000191:economics; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D008670:Metals
keywords: coronary artery disease; direct stenting; stents