Publication Sub Type
Journal Article, Original
Philippine Heart Center Journal
Background. Coronary stent implantation is being performed in stenosed coronary artery with long term
outcome improvements and improvement of the patency in treated vessels. Conventional coronary stenting
includes standard balloon angioplasty (predilation) followed by stent deployment. Stenting without predilation
with balloon is termed direct coronary stenting. This approach help reduce procedure time, cost, reduced risk
of extended dissections, radiation exposure, reduce vessel trauma and lessen neointimal hyperplasia which
can lower the incidence of subsequent restenosis. With these, direct stenting is now the primary therapeutic
option for many coronary lesions.
Methods. Patients with stable coronary artery disease (CAD) who underwent elective single stent implantation in a native coronary artery between January to November 2011 at the Philippine Heart Center were included in the study. In-hospital as well as 1 month follow-up of major adverse cardiovascular and cerebrovascular events (MACCE) were noted and compared between the two groups.
Results. A total of 229 patients, 129 in the direct stent group and 100 for the conventional group, were included in the study. There was no Significant difference in the demographic, angiographic, and procedural characteristics between the two groups except for stent stenosis before the procedure, stent length, and maximum inflation pressure. Adjustment for covariates between these three parameters did not show any significant difference in terms of outcome. Angiographic success based on residual stenosis was comparable between the two strategies. In-hospital and 1 month MACCE were similar in both groups.
Conclusions. Compared to conventional stenting, direct stenting is a safe and feasible procedure in selected coronary lesions in terms of angiographic success based on residual stenosis and in-hospital and 1 month MACCE.