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. |
