COMPARISON OF IMMEDIATE AND LATE OUTCOMES AFTER DIRECT AND CONVENTIONAL STENT IMPLANTATION IN PATIENTS WITH ISCHEMIC HEART DISEASE

Abstract

lntracoronary stent placement has rapidly evolved into a primary strategy for percutaneous revascularization of symptomatic obstructive coronary arten•a1 1es1•0ns I 1- 4 l .

l"he standard stent implantation techniques involves predilatation of the target lesion with a balloon catheter to allow easy passage of the stent and to assess the likelihood of complete stent expansion after deployment < 51 . These changes in the technique of stent implantation will have important implications on cost-effectiveness by directly reducing material consumption 1 61 .

With improvement in stent designs , including lower profile and greater flexibility cif second generation stents , placement of stents without balloon predilatation becomes more widespread < 7 1 •

Coronary stenting has revolutionized the field of interventional cardiology, which previously relied on balloon dilation in the majority of patients. This rapid acceptance of coronary stenting has been due to two main factors. First, large randomized multicenter trials have shown that stenting has a lower restenosis rate and a better long-term clinical outcome than coronary balloon angioplasty in de novo or restenotic lesions . Fmihermore, smaller non-randomized studies have also demonstrated that stenting can improve primary and long-term success in lesions with high recurrence rates after balloon angioplasty, such as stenosis in vein bypass grafts, amio-ostial stenosis and chronic total occlusion (I ,2) . Second, stent thrombosis, bleeding and vascular