Comparison of the sheath delivery system versus bare stenting for coronary stent implantation

Abstract

Outside the United States, Palmaz-Schatz coronary stents are implanted by handcrimping the stent to a high pressure balloon without the use of a protective sheath. This lowers the delivery profile, increases the ease of deployment, and ensures that the postdilatation balloon is centered on the stent. To assess this bare stenting technique, 209 patients were retrospectively analyzed: 92 patients (107 lesions) with the sheath protected stent delivery system (SDS) and 117 patients (150 lesions) with the bare stent approach. The number of balloons used per lesion in the bare stent group was significantly less than in the SDS group (1.9 ؎ 0.6 vs. 3.8 ؎ 1.2, P F 0.0001). In addition, the procedure time in the bare stent group was significantly shorter than in the SDS group (106 ؎ 55 vs. 134 ؎ 60 min, P ‫؍‬ 0.001). There was no difference in frequency of adverse events or stent displacement during the procedure. The bare stenting technique decreases the procedure time, reduces the number of balloons used, and is as safe as the SDS approach.

Influence of stent design on 1-year outcome after coronary stent placement: A randomized comparison of five stent types in 1,147 unselected patients

“…Although no differences between sheath delivery system and bare stenting have been reported with respect to patient's early outcome [39], there are no long-term comparative data. It was not our goal to perform paired comparisons between the various stent types employed and this study lacks sufficient statistical power to do this.…”