Effectiveness of “Direct” Stenting Without Balloon Predilatation (from the Multilink Tetra Randomised European Direct Stent Study [TRENDS])

Direct Stenting With the TAXUS Liberté Drug-Eluting Stent

“…As a thin-strut drug-eluting stent with a lower profile and increased flexibility for enhanced deliverability and conformability, TAXUS Liberté is suitable for direct stenting in selected patients. Indeed, direct stenting was successful in 97.6% of patients in this study, which is similar to the best results reported with bare metal stents in somewhat simpler lesions (1)(2)(3)(4)(5).…”

“…The introduction of more flexible, lower-profile, balloon-expandable stents has made direct stenting (i.e., without pre-dilation) more common. Studies using bare metal stents have proven that direct stenting is safe and effective in patients selected for favorable anatomy, with outcomes similar to stenting after predilation but with reduced procedural time and cost (1)(2)(3)(4)(5).…”

Direct Stenting for Stable Angina Pectoris Is Associated With Reduced Periprocedural Microcirculatory Injury Compared With Stenting After Pre-Dilation

“…Several studies demonstrated this technique to be feasible and safe in selected cases resulting in reduced procedural costs, duration, and radiation exposure (1). However, in randomized trials, the DS technique showed similar results to standard CS for long-term clinical outcome (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). Experimental and indirect clinical data support the concept of reduced wall damage and distal embolization when stent deployment is performed without balloon pre-dilation (14,15).…”

Direct stenting compared to balloon predilation in drug‐eluting stents

“…Specifically, DS with BMS has been shown to result in shorter procedural times with less fluoroscopic exposure, contrast use, and financial costs [8][9][10][11][12]. Subsequent randomized studies demonstrated similar clinical and angiographic results in short-term follow-up without an increase rate of TLR [13,14].…”