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Direct coronary stenting: Effect on coronary blood flow, immediate and late clinical results
Author(s) -
Capozzolo Claudia,
Piscione Federico,
De Luca Giuseppe,
Cioppa Angelo,
Mazzarotto Pietro,
Leosco Dario,
Golino Paolo,
Indolfi Ciro,
Chiariello Massimo
Publication year - 2001
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.1204
Subject(s) - medicine , timi , lesion , stenosis , stent , cardiology , target lesion , surgery , myocardial infarction , percutaneous coronary intervention
Direct stenting (DS) was attempted in 99 coronary lesions in 94 patients while standard stenting (SS) was attempted in 113 lesions in 103 patients matched for clinical characteristics, stenosis type, and location and stent type. The angiographic result was also evaluated according to TIMI frame count method (TFC) before and after procedure. A clinical follow‐up was performed 1 year after the procedure. Before the procedure, TIMI grade 3 flow was detected in 42 cases (42.4%), grade 2 in 40 cases (40.4%), grade 1 in 5 cases (5.1%), and grade 0 in 12 cases (12.1%) in the DS group; these data were similar in SS group. After the procedure, TIMI grade flow was 3 in 90 cases (92.8%) in DS group and in 87 (77.0%) in SS group ( P < 0.005); grade 2 was observed in 7 case (7.2%) in DS group and in 25 (22.1%) in SS group ( P < 0.005). Major adverse cardiac events during hospitalization and at follow‐up were similar in two groups. Radiation exposure time and procedure costs per lesion were significantly reduced in DS group compared to SS group (10.1 ± 8 min vs. 13.9 ± 4.7 min, P < 0.001; and 1901 ± 687 Euro vs. 2352 ± 743 Euro, P < 0.001, respectively). This study confirms that, in selected patients, direct stenting is a safe and successful procedure, allowing a significant reduction in radiation exposure time and procedural costs compared to standard stenting technique. The angiographic success is confirmed by the improvement in TFC in all cases. Cathet Cardiovasc Intervent 2001;53:464–473. © 2001 Wiley‐Liss, Inc.