Twelve-month outcome after coronary stent implantation without predilatation

Abstract

Stent implantation has traditionally been performed after predilatation of the stenotic lesion with a conventional catheter balloon, thus allowing the lesion to be crossed easily. As a result of the improved design of the stent delivery systems with lower crossing profiles and greater flexibility and better stent stability on the balloon, predilatation may not be necessary in some cases. The clinical feasibility, efficacy, and procedural safety of direct stenting in selected groups of patients have been shown in recent reports. 1 Pentousis D. Guérin Y. Funk F. Zheng H. Toussait M. Corcos T. Favereau X. Direct stent implantation without predilatation using the MultiLink stent. Am J Cardiol. 1998; 82: 1437-1440 Abstract Full Text Full Text PDF PubMed Scopus (94) Google Scholar , 2 Herz I. Assali A. Solodky A. Shor N. Pardes A. Ben-Gal T. Adler Y. Effectiveness of coronary stent deployment without predilatation. Am J Cardiol. 1998; 84: 89-91 Abstract Full Text Full Text PDF Scopus (27) Google Scholar , 3 Herz I. Assali A. Solodky A. Shor N. Ben-Gal T. Adler Y. Birnbaum Y. Coronary stent deployment without predilatation in acute myocardial infarction A feasible, safe, and effective technique. Angiology. 1998; 50: 901-908 Crossref Scopus (17) Google Scholar , 4 Hamon M. Richardeau Y. Lécluse E. Saloux E. Sabatier R. Agostini D. Filmont J.E. Grollier G. Potier J.C. Direct coronary stenting without balloon predilatation in acute coronary syndromes. Am Heart J. 1998; 138: 55-59 Abstract Full Text Full Text PDF Scopus (74) Google Scholar , 5 Briguori C. Sheiban I. De Gregorio J. Anzuini A. Montorfano M. Pagnotta P. Marsico F. Leonardo F. Di Mario C. Colombo A. Direct stenting without predilatation. J Am Coll Cardiol. 1998; 34: 1910-1915 Abstract Full Text Full Text PDF Scopus (127) Google Scholar , 6 Taylor AJ, Broughton A, Federman J, Walton A, Keighley C, Haikerwal D, Krawczyszyn M, Shaw J, Goods C. Efficacy and safety of direct stenting in coronary angioplasty. J Invasive Cardiol 2000;12:560–565. Google Scholar This technique reduces the procedure time and radiation exposure times and costs. 7 Ormiston J.A. Webster M.W.I. Ruygrok P.N. Elliot J.M. Simmonds M.B. Meredith I.T. Devlin G.P. Stewart J.T. Dixon S.R. Price S. et al. A randomized study of direct coronary stent delivery compared with stenting after predilatation. Cathet Cardiovasc Intervent. 1998; 50: 377-381 Crossref Scopus (46) Google Scholar , 8 Chan A.W. Carere R.G. Solankhi N. Dodek A. Webb J.G. Coronary stenting without predilatation in broad spectrum of clinical and angiographic situations. J Invasive Cardiol. 1998; 12: 75-79 Google Scholar In addition, it may cause less myocardial ischemia due to a decrease in balloon inflations. However, there are few reports about mid- and long-term outcome after direct stenting. 9 Wilson S.H. Berger P.B. Mathew V. Bell M.R. Garratt K.N. Rihal C.S. Bresnahan J.F. Grill D.E. Melby S. Holmes D.R. Immediate and late outcomes after direct stent implantation without balloon predilatation. J Am Coll Cardiol. 1998; 35: 937-943 Abstract Full Text Full Text PDF Scopus (101) Google Scholar , 10 Danzi G.B. Capuano C. Fiocca L. Dallavalle F. Pirelli S. Mauri L. Quaini E. Stent implantation without predilatation in patients with a single, noncalcified coronary artery lesion. Am J Cardiol. 1998; 84: 1250-1253 Abstract Full Text Full Text PDF Scopus (44) Google Scholar , 11 Oemrawsingh P.V. Schlij M.J. Srimahachota S. Jukema J.W. Bruschke A.V.G. Clinical and angiographical outcome of stent implantation without predilatation using the Jostent Flex Stent. J Invasive Cardiol. 1998; 12: 187-193 Google Scholar The purpose of the present study was first, to know the clinical and angiographic restenosis rate in patients in whom direct stenting was successfully implanted and also to identify clinical, lesional, and procedural variables predictive of angiographic restenosis after direct stent implantation.