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Direct stenting could potentially lead to a reduction in dissections, time, and restenosis at 6‐month follow‐up. Using the premounted Palmaz‐Schatz Crown stent elective stenting was performed without predilatation in 61 consecutive patients who were compared with a control group of provisional stenting. All patients underwent clinical and angiographic follow‐up at 6 months. Direct stenting was successful in 81% of patients. In 16% of the patients predilatation was needed. In 3% the stent could not be implanted despite predilatation. Stent dislodgment occurred in 2% of patients, without embolization. Six‐month angiographic follow‐up was performed in 51 (84%) of 61 patients. In the direct stenting group the mean preprocedural minimal luminal diameter (MLD) increased from 0.96 ± 0.47 to 3.09 ± 0.54 mm directly after the procedure. At 6‐month follow‐up the MLD measured 2.32 ± 0.79 mm. In the provisional stenting group the mean MLD increased from 0.92 ± 0.51 to 2.44 ± 0.58 mm and was 1.84 ± 0.70 mm at 6‐month follow‐up. Restenosis, defined as a diameter stenosis > 50%, occurred in 8% of the direct stenting group compared with 28% in the provisional stenting group (P<0.001). Direct coronary stent implantation can be attempted safely and efficaciously. The risk of stent loss is low. The initial and long‐term angiographic results are significantly better as compared with provisional stenting. The risk of restenosis is significantly lower.
Journal of Interventional Cardiology – Wiley
Published: Aug 1, 2002
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