Document Detail


Comparison of direct stenting versus stenting with predilation for the treatment of selected coronary narrowings.
MedLine Citation:
PMID:  11792327     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Direct stenting may reduce costs, procedure times, and injury to the vessel wall, positively influencing acute and late results. This study was designed to demonstrate 6-month clinical outcome equivalence between direct and standard stenting techniques. Four hundred eleven patients (425 lesions) were randomized in 7 sites to undergo direct (210 patients, 216 lesions) or conventional (201 patients, 209 lesions) stent implantation. Lesions with severe calcification were excluded. Angiographic success rate was 100% in the direct stent group (2.8% requiring balloon predilation) and 98.6% in the predilation group (p = 0.12). Direct stenting was associated with decreased use of balloons (0.15 vs 1.09 balloons/lesion treated) and with a trend toward a reduction of procedure time (22.7 +/- 15.0 vs 25.6 +/- 18.2 minutes; p = 0.073). Fluoroscopy time and contrast volume were not different between groups. At 6-month follow-up, the incidences of death (direct [1.4%] vs predilation [2.5%]), myocardial infarction (5.3% vs 5.0%), and target vessel revascularization (8.2% vs 10.5%) were similar in both groups. Major adverse cardiac event-free survival rate was 87.5% for those who underwent the direct stent technique and 85.5% for patients who underwent predilation (p = 0.0002 for equivalence). In conclusion, direct stenting is at least equivalent to the standard technique in terms of 6-month clinical outcomes when performed on selected coronary lesions without significant calcification. This strategy is associated with decreased use of balloons, but, in general, does not significantly reduce procedure times.
Authors:
Fábio S Brito; Adriano M Caixeta; Marco A Perin; Miguel Rati; J Airton Arruda; Marcelo Cantarelli; Hélio Castello; Bruno M Machado; Lélio A Silva; Expedito E Ribeiro; Protásio L da Luz;
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  The American journal of cardiology     Volume:  89     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2002 Jan 
Date Detail:
Created Date:  2002-01-16     Completed Date:  2002-02-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  115-20     Citation Subset:  AIM; IM    
Affiliation:
Albert Einstein Hospital, São Paulo, Brazil. fsbrito@einstein.br
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon*
Brazil
Chi-Square Distribution
Coronary Angiography
Coronary Stenosis / mortality,  surgery*
Female
Humans
Male
Middle Aged
Postoperative Complications / epidemiology
Stents*
Survival Rate
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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