title: Svelte integrated delivery system performance examined through diagnostic catheter delivery: the SPEED registry.
abstract: OBJECTIVE
  The multi-center SPEED registry evaluated the procedural success and in-hospital clinical outcomes of direct stenting with the Svelte 'all-in-one' coronary stent Integrated Delivery System (IDS) through diagnostic catheters to identify the clinical indications for which this approach is appropriately suited.
  
  
  RESULTS
  Forty-eight (48) patients with 54 lesions of lengths ≤20 mm and RVD 2.5-3.5 mm were targeted for direct stenting through diagnostic catheters (4-6F) via radial or femoral approach. Procedural characteristics early in an investigator's experience (28 lesions) were compared with outcomes following experience (26 lesions). Procedure, device and strategy success were realized in 54 (100%), 50 (93%) and 46 (85%) lesions, respectively, with strategy success significantly related to RVD (P = 0.05), lesion location (P = 0.01), and diagnostic catheter size (P = 0.05). Significant improvement in crossing and intervention time and trends toward improvement in device and strategy success, reductions in procedure and radiation time and contrast use were observed.
  
  
  CONCLUSIONS
  Direct stenting through diagnostic catheters via radial or femoral approach using the Svelte IDS is feasible and associated with good in-hospital outcomes. This approach offers the attractive option of assessing lesions via diagnostic catheter and, depending upon vessel anatomy and lesion morphology, continuing with ad-hoc interventional treatment using the same diagnostic catheter. Improvements in strategy success and procedural efficiencies, based on operator experience, facilitate catheter downsizing and reduce intervention time, ancillary product use and overall procedure costs. © 2014 Wiley Periodicals, Inc.
authors.affiliation: Department of Cardiology, Bern University Hospital, Bern, Switzerland.
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Khattab
authors.forename: Freek
authors.initials: F
authors.lastname: Nijhoff
authors.forename: Joachim
authors.initials: J
authors.lastname: Schofer
authors.forename: Jacques
authors.initials: J
authors.lastname: Berland
authors.forename: Bernhard
authors.initials: B
authors.lastname: Meier
authors.forename: Fabian
authors.initials: F
authors.lastname: Nietlispach
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Agostoni
authors.forename: Steffen
authors.initials: S
authors.lastname: Brucks
authors.forename: Pieter
authors.initials: P
authors.lastname: Stella
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation* / Q000401:mortality; D062906:Cardiac Catheters / Q000191:economics; D002983:Clinical Competence; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000191:economics / Q000401:mortality / Q000628:therapy*; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D004867:Equipment Design; D005060:Europe; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery; D017048:Health Care Costs; D006801:Humans; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation* / Q000401:mortality; D011446:Prospective Studies; D017534:Radial Artery; D012042:Registries; D015607:Stents / Q000191:economics; D013997:Time Factors; D016896:Treatment Outcome
keywords: coronary artery disease; diagnostic cardiac catheterization; direct stenting; percutaneous coronary intervention