Why the study?
Does direct stenting prevent dissections and reduce the length of stents implanted compared to conventional stenting?
Does direct stenting prevent dissections and reduce the length of stents implanted compared to conventional stenting?
Direct stenting is safe, reduces the incidence of dissections, and lowers periprocedural creatine kinase elevation compared to conventional stenting, although it does not significantly reduce total stent length.
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Direct stenting lowers dissection risk versus conventional PCI; reinforces RCT evidence favoring its use in suitable lesions.
With conventional stenting, predilatation frequently induces dissections that require deploying stents longer than originally planned. To assess whether direct stenting is safe and may prevent dissections and reduce the length of stents implanted, we conducted a randomized study comparing direct (n = 73) and conventional (n = 78) stenting. Direct stenting was successful in 89% of cases, 11% crossed over to predilation without complications. Dissections occurred more frequently in conventional stenting group (10.3% vs. 1.4%; P = 0.034), but did not translate to a significant stent length difference (16.31 +/- 7.6 vs. 15.31 +/- 5.5; P = NS). Periprocedure creatine kinase elevation and number of balloons utilized were lower with direct stenting.
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Ballarino et al. (2003) studied this question.
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