Direct coronary stenting versus predilatation followed by stent placement

The independent value of a direct stenting strategy on early and late clinical outcomes in patients undergoing elective percutaneous coronary intervention

“…2. These results are in accordance to previous studies reporting that DS fails to reduce the rate of restenosis [4,22,23] as it had been initially postulated by preclinical and observational studies [6,14,24]. Our findings regarding other late clinical outcomes, such as MACE and ST, are also supported by the existing literature [3][4][5]25].…”

“…Although randomized trials have shown similar late clinical outcomes for DS [3][4][5], a higher incidence of stent edge restenosis with PD is proposed and is explained by geographical miss and uncovered balloon injury outside the stent edges [6,7]. Likewise, differences in early clinical events, such as the incidence of periprocedural myocardial injury (PPMI) [6,[7][8][9][10] and the frequency of no-reflow phenomenon [11][12][13], are anticipated to occur less frequently with DS, which is attributed to less wall damage [14,15] and a reduction in particle embolization [3,4,15] when PD is avoided.…”

“…Likewise, differences in early clinical events, such as the incidence of periprocedural myocardial injury (PPMI) [6,[7][8][9][10] and the frequency of no-reflow phenomenon [11][12][13], are anticipated to occur less frequently with DS, which is attributed to less wall damage [14,15] and a reduction in particle embolization [3,4,15] when PD is avoided.…”

Radiation Exposure to Patients Undergoing Percutaneous Coronary Interventions

“…Mean values were reported in the range of 8.2-21 min for PCI [14,22,39,46], of 8.7-16 min for PCI plus stenting [9-11, 21, 22], and of 10.1-12.6 min for direct stenting [9][10][11]21]. In this study, T F indeed increased for complex interventions like recanalizations of chronic coronary occlusions, emergency interventions, and ELCA.…”

Direct Stenting Versus Predilatation and Stenting Technique When Using Paclitaxel-Eluting Stents

“…11,22) There are data demonstrating less vascular endothelial trauma with direct stenting, and this evidence might be a potential basis for expecting less in-stent restenosis with this technique. 23,24) Although lower restenosis rates are achieved with direct stenting in some studies when implanting bare metal stents, 3,25) the rate of restenosis is considered similar either with direct stenting or predilatation in bare metal stent implantation. 26) Studies have also failed to demonstrate such a positive effect of direct stenting on restenosis when implanting drug-eluting stents.…”