Background: Direct stenting (DS) or balloon pre dilatation
according to scenarios of cases as in thrombotic lesions where
operators usually attempt DS to avoid distal embolization and
no-reflow, unless balloon pre-dilation is needed due to
inadequate visualization of the distal vessels to deployment the
stent In non-calcified , non-complex lesions the operator
usually choose direct stent strategy but in lesions with high
degree complexity and /or severe calcification usually needed
balloon pre-dilatation before stent deployment. Methods: This
randomized clinical trial study was conducted on 80 patients in
the Cardiovascular Medicine Department of Matria Teaching
Hospital (MTH) and Cardiovascular Department, Faculty of
Medicine, Benha University. All studied cases were subjected
to the following: Detailed history taking, including [Personal
history, risk factors, family history, Clinical examination,
Laboratory investigations included complete blood count
(CBC), Creatinine, urea, and international normalized ratio
(INR), Investigations included (12-lead electrocardiogram
(ECG), echocardiography Complete comprehensive
transthoracic echocardiographic examinations Results: At 3-
months follow-up, Hb concentration was significantly lower in
group 1 compared to group 2 (P=0.028), with no significant
difference between both groups regarding serum creatinine
level. Regarding the outcome at 3-months follow-up, recurrent symptoms were observed in
10 (25%) patients in group 1 and 7 (17.5%) patients in group 2, myocardial infarction
occurred only in 1 (2.5%) patient in group 2, arrhythmia occurred in 2 (5%) patients in
group 1 and 3 (7.5%) patients in group 2 and heart failure occurred in 7 (17.5%) patients in
group 1 and 9 (22.5%) patients in group 2. No cases of death were observed in any of the
studied groups. Conclusion: Direct stenting was associated with significantly shorter
procedural times and a lower volume of contrast compared to the balloon pre-dilatation
strategy. There was also a tendency toward lower hemoglobin Hb levels with direct
stenting at 3-month follow-up; the clinical relevance of this finding remains unknown,
Department of Cardiology,
Faculty of Medicine, Benha
University, Egypt.
Corresponding to: Ahmed H.
Ibrahim, Department of
Cardiology, Faculty of Medicine
Benha University, Egypt.
Email:
ahmedhamzacardio@gmail.com
Received:
Accepted:
Print ISSN 1110-208X
Online ISSN 2357-0016
Benha medical journal, vol. XX, issue XX, 2024
taking into account that there was no significant outcome difference between both
strategies. |
