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Direct coronary stenting without balloon or device pretreatment: Acute success and long‐term results
Author(s) -
Stys Tomasz,
Lawson William E.,
Liuzzo John P.,
Hanif Bashir,
Bragg Lloyd,
Cohn Peter F.
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.1258
Subject(s) - medicine , mace , cardiology , conventional pci , angioplasty , myocardial infarction , revascularization , balloon , coronary stenting , stent , surgery , restenosis
Improvements in coronary stents have made planned direct coronary stenting technically feasible, though safety, acute success, cost‐effectiveness, and long‐term results remain to be determined. Sequential patients eligible for direct stenting were prospectively characterized and treated with either direct or secondary stenting. Major adverse cardiovascular events (MACE) such as cardiac death, myocardial infarction (MI), target vessel ischemia, or revascularization (TVR) were followed for 6 months post‐PCI. Enrollment included 128 direct (1.38 lesions/patient) and 69 secondary (1.39 lesions/patient) stented patients. Direct stenting was successful in 99% (with 5% crossover to secondary stenting) without major procedural complications and with a similar rate of vessel wall dissection or no‐reflow phenomenon (2.3% vs. 2.1%; P > 0.05) as the secondary stenting group. There was a trend toward less postprocedural CPK‐MB elevation in the nonacute MI patients with direct vs. secondary stenting (3% vs. 11%, respectively). At 6 months, there were no statistically significant differences in overall MACE. Direct stenting has a high success rate, low complication rate, and durable long‐term results. Procedural cost and time savings, less contrast use and radiation exposure make direct stenting attractive in properly selected patients. Cathet Cardiovasc Intervent 2001;54:158–163. © 2001 Wiley‐Liss, Inc.