Direct stenting versus conventional stenting of coronary artery lesions
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With improvement in stent design, direct stent implantation without predilatation has become a promising new technique that may reduce the procedure time, radiation exposure time and cost. The aim of this study was to assess the safety and feasibility of direct stenting and to compare the direct stenting with conventional stenting. The study was carried on forty patients with LAD lesion. Twenty patients were treated with direct stenting and twenty patients with conventional stenting. The two groups of patients were homogeneous as regard risk factors and lesion characteristics. The two groups were followed for six months both clinically and by exercise test at three and six months. The procedural success rate was 100% in the two groups. One case in the group of direct stenting developed subacute thrombosis because the patients stopped the antiplatelets. Four patients in each group developed in-stent restenosis. There was no difference between the two groups as regard the early outcomes, the cardiac events rate at follow up for six months and the complications. Direct stenting is as safe as pre-dilated stenting in selected coronary lesions. Acute angiographic results are similar but procedural costs, duration of the procedure, radiation exposure and contrast agent are lower in direct stenting. Overall success rate, mid-term clinical outcome and restenosis are similar with both technique.