Coronary stent implantation without lesion predilatation (direct stenting): our experience with this evolving technique.

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dc.contributor.authorSapra, Ren_US
dc.contributor.authorKaul, Uen_US
dc.contributor.authorSingh, Ben_US
dc.contributor.authorSudan, Den_US
dc.contributor.authorIsser, H Sen_US
dc.contributor.authorGhose, Ten_US
dc.contributor.authorKachru, Ren_US
dc.date.accessioned2001-05-23en_US
dc.date.accessioned2009-05-27T04:29:22Z
dc.date.available2001-05-23en_US
dc.date.available2009-05-27T04:29:22Z
dc.date.issued2001-05-23en_US
dc.description.abstractBACKGROUND: Until recently, conventional intracoronary stent deployment required predilatation of the lesion with a balloon. However, "direct stenting" of the lesion without predilatation offers certain theoretical and practical advantages. We assessed the safety and feasibility of direct stenting in a select group of patients who were likely to benefit most from these advantages, namely, those with acute coronary syndromes. saphenous vein graft lesions, associated renal or left ventricular dysfunction and those requiring multivessel intervention. METHODS AND RESULTS: After direct stenting, intravascular ultrasound was used to assess the adequacy of stent expansion in 51 patients. One hundred and twenty patients with a total of 125 lesions (83.3% males, average age 54.6+/-12.4 years) were enrolled for direct stenting. Of these, 90% of patients had presented with acute coronary syndromes, 21.6% of patients had associated moderate-to-severe left ventricular systolic dysfunction, 6.7% of patients had associated renal dysfunction and 30.8% of patients required multivessel intervention. Angiographically visible thrombus was present in 35.2% of patients. The mean reference diameter of the lesion was 3.18+/-0.32 mm and mean percentage diameter stenosis was 76.4+/-11.2%. Almost all varieties of stents were used (8.8% bare and 91.2% mounted). Procedural success was achieved in 98.3% of patients (98.4% of lesions). In two cases, the lesion had to be predilated prior to stenting. On angiography, the need for postdilatation of the stent was apparent in 29 (23.6%) lesions. In contrast, on intravascular ultrasound evaluation done in 51 lesions after stent deployment, the need for postdilatation to optimize stent expansion was seen in 43 (84.3%) lesions. There was one instance of acute stent thrombosis and two instances of slow-flow phenomenon. There were no deaths, myocardial infarction or need for urgent bypass surgery. CONCLUSIONS: We conclude that direct stenting is feasible and safe in selected groups of patients. Optimization of stent expansion after direct stenting may often require aggressive postdilatation.en_US
dc.description.affiliationDepartment of Interventional Cardiology, Batra Hospital and Medical Research Centre, New Delhi, India.en_US
dc.identifier.citationSapra R, Kaul U, Singh B, Sudan D, Isser HS, Ghose T, Kachru R. Coronary stent implantation without lesion predilatation (direct stenting): our experience with this evolving technique. Indian Heart Journal. 2001 May-Jun; 53(3): 308-13en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/5840
dc.language.isoengen_US
dc.source.urihttps://indianheartjournal.comen_US
dc.subject.meshCoronary Disease --therapyen_US
dc.subject.meshCoronary Vessels --ultrasonographyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMyocardial Reperfusion --methodsen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshStents --adverse effectsen_US
dc.subject.meshUltrasonography, Interventionalen_US
dc.titleCoronary stent implantation without lesion predilatation (direct stenting): our experience with this evolving technique.en_US
dc.typeClinical Trialen_US
dc.typeJournal Articleen_US
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