Document Detail


Could direct stenting reduce no-reflow in acute coronary syndromes? A randomized pilot study.
MedLine Citation:
PMID:  12075259     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Recently, direct stenting has been shown in retrospective and randomized studies to be feasible and safe in highly selected patients, with a potential interest to reduce the cost of the procedure and the rate of no-reflow. This randomized pilot study was designed to compare the incidence of no-reflow after direct stenting or conventional stenting after balloon predilation in acute coronary syndrome-related lesions. METHODS AND RESULTS: Between December 1998 and October 1999, 130 patients in our center with acute coronary syndromes were included in this study and randomized in 2 groups. In group A (n = 65), direct stent implantation was performed without balloon predilation. In group B (n = 65), conventional balloon predilation was carried out before stent implantation. Baseline clinical and angiographic characteristics before the procedure were similar in the 2 groups of patients. No-reflow was observed in 7.7% after direct stenting and in 6.1% after conventional stent implantation (P = not significant). The immediate clinical success rate was similar in the 2 groups. Among the procedural data, only duration of the procedure (shorter in the direct stenting group), the number of balloons used, and the quantity of contrast agent (lower in the direct stenting group) were significantly different between the 2 groups (P <.05). The 6-month clinical outcome was similar in the 2 groups. CONCLUSION: This randomized study confirms the promising results of previous studies that show the feasibility and the safety of direct coronary stenting in highly selected acute coronary syndrome-related lesions. The major impact of this strategy is the improvement of the cost-benefit ratio, with no major influence on the acute complications and especially on the occurrence of no-reflow in this high-risk population.
Authors:
Rémi Sabatier; Martial Hamon; Quan Ming Zhao; Francesco Burzotta; Emmanuel Lecluse; Benoit Valette; Gilles Grollier
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American heart journal     Volume:  143     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-06-20     Completed Date:  2002-07-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1027-32     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, University Hospital of Caen, Caen, France.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Aged, 80 and over
Angina, Unstable / therapy*
Angioplasty, Transluminal, Percutaneous Coronary* / adverse effects,  economics
Coronary Angiography
Coronary Circulation
Feasibility Studies
Female
Humans
Male
Middle Aged
Myocardial Infarction / therapy*
Patient Selection
Pilot Projects
Safety
Statistics as Topic
Stents* / adverse effects,  economics
Syndrome

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


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