Stent implantation without predilation in patients with a single, noncalcified coronary artery lesion

Danzi, Gian Battista; Capuano, Cinzia; Fiocca, Luigi; Dallavalle, Francesco; Pirelli, Salvatore; Mauri, Luigi; Quaini, Eugenio

doi:10.1016/s0002-9149(99)00540-8

Cited by 48 publications

(30 citation statements)

References 14 publications

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“…This observational study showed that direct stent implantation using a 5F guiding catheter and the transradial approach is feasible, safe, and effective, achieving a very low complication rate, almost zero. Other studies have already demonstrated that direct stent implantation without predilation is a safe and effective technique [7][8][9][10] , but the use of a 5F guiding catheter and the transradial approach has been demonstrated only in a series of patients selected with acute ischemic syndromes 11 .…”

Section: Discussionmentioning

confidence: 99%

Implante direto de stent através de cateter guia 5F por técnica transradial

Coelho¹,

Jacob²,

Filho³

et al. 2004

Arq. Bras. Cardiol.

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Section: Discussionmentioning

confidence: 99%

Implante direto de stent através de cateter guia 5F por técnica transradial

Coelho¹,

Jacob²,

Filho³

et al. 2004

Arq. Bras. Cardiol.

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“…On the other hand, no data from randomized studies testing the different occurrence (if any) of restenosis after direct and standard stenting are available, but the only small series of patients who underwent a coronary angiography after either direct and standard stenting did not show any difference [27]. Probably, only randomized, large studies with rigorous patients and lesions selection could demonstrate such an occurrence of reduced restenosis after DS.…”

Section: Study Limitationmentioning

confidence: 98%

Direct coronary stenting: Effect on coronary blood flow, immediate and late clinical results

Capozzolo

Piscione

Luca

et al. 2001

Cathet Cardio Intervent

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Direct stenting (DS) was attempted in 99 coronary lesions in 94 patients while standard stenting (SS) was attempted in 113 lesions in 103 patients matched for clinical characteristics, stenosis type, and location and stent type. The angiographic result was also evaluated according to TIMI frame count method (TFC) before and after procedure. A clinical follow-up was performed 1 year after the procedure. Before the procedure, TIMI grade 3 flow was detected in 42 cases (42.4%), grade 2 in 40 cases (40.4%), grade 1 in 5 cases (5.1%), and grade 0 in 12 cases (12.1%) in the DS group; these data were similar in SS group. After the procedure, TIMI grade flow was 3 in 90 cases (92.8%) in DS group and in 87 (77.0%) in SS group (P < 0.005); grade 2 was observed in 7 case (7.2%) in DS group and in 25 (22.1%) in SS group (P < 0.005). Major adverse cardiac events during hospitalization and at follow-up were similar in two groups. Radiation exposure time and procedure costs per lesion were significantly reduced in DS group compared to SS group (10.1 +/- 8 min vs. 13.9 +/- 4.7 min, P < 0.001; and 1901 +/- 687 Euro vs. 2352 +/- 743 Euro, P < 0.001, respectively). This study confirms that, in selected patients, direct stenting is a safe and successful procedure, allowing a significant reduction in radiation exposure time and procedural costs compared to standard stenting technique. The angiographic success is confirmed by the improvement in TFC in all cases.

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“…The stent was implanted using balloon predilation in 85% of the cases and by means of a direct stenting technique in the remaining patients [6]. Different newgeneration stents were used, with a diameter of between 2.0 and 4.5 mm and a length of 8 -30 mm: NIR Elite (n ϭ 334; Scimed, Boston Scientific, Maple Grove, MN), NIR Elite Royal Advance (n ϭ 147; Scimed), Express (n ϭ 182; Scimed), Multilink Tetra (n ϭ 312; ACS, Guidant, Temecula, CA), Multilink Penta (n ϭ 124; ACS), Bx Velocity (n ϭ 137; Cordis, Johnson and Johnson, Warren, NJ), Bx Sonic (n ϭ 112; Cordis; n ϭ 85), Biodivysio (n ϭ 154; Biocompatibles, Galway, Ireland), and Tsunami (n ϭ 91; Terumo, Osaka, Japan).…”

Section: Stent Proceduresmentioning

confidence: 99%

Nonionic low‐osmolar contrast media have no impact on major adverse cardiac events in patients undergoing coronary stenting with appropriate antiplatelet therapy

Danzi

Capuano

Sesana

et al. 2003

Cathet Cardio Intervent

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The aim of this study was to assess the impact of two nonionic low-osmolar monomers (iopamidol and iopromide) and one ionic low-osmolar dimeric contrast medium (ioxaglate) on 30-day major adverse cardiac events in patients undergoing coronary interventions involving the use of new-generation stents and appropriate antiplatelet agents. Thirteen hundred and eight patients treated with stent implantation were randomized to receive ioxaglate (438 patients), iopamidol (442 patients), or iopromide (428 patients). Most of them (55%) had an acute coronary syndrome. Glycoprotein IIb/IIIa inhibitors were used in 37% of cases. All of the patients were on aspirin and ticlopidine for 1 month after the procedure. There was no significant between-group difference in the incidence of the primary composite endpoint of major adverse cardiac events 30 days after stenting (ioxaglate 3.6%; iopamidol 2.3%; iopromide 4.2%; P = 0.27). Adverse drug reactions were more frequent in the ioxaglate group (4.6% vs. 1.1% vs. 0.5%; P = 0.001). Multivariate analysis showed that intracoronary thrombus (P = 0.002), diabetes mellitus (P = 0.01), and postprocedure minimum lumen diameter (P = 0.04) independently correlated with an adverse outcome after 1 month. In conclusion, no significant differences in 30-day major ischemic complications were observed in this unselected population of patients undergoing coronary stenting who received ioxaglate, iopamidol, or iopromide. These data seem to suggest that the use of nonionic low-osmolar contrast media does not adversely affect stent patency.

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Stent implantation without predilation in patients with a single, noncalcified coronary artery lesion

Cited by 48 publications

References 14 publications

Implante direto de stent através de cateter guia 5F por técnica transradial

Implante direto de stent através de cateter guia 5F por técnica transradial

Direct coronary stenting: Effect on coronary blood flow, immediate and late clinical results

Nonionic low‐osmolar contrast media have no impact on major adverse cardiac events in patients undergoing coronary stenting with appropriate antiplatelet therapy

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