Direct coronary stenting versus stenting with balloon pre-dilation: immediate and follow-up results of a multicentre, prospective, randomized study. The DISCO trial. DIrect Stenting of COronary Arteries. European heart journal. [Eur Heart J] Journal article | | Title | Direct coronary stenting versus stenting with balloon pre-dilation: immediate and follow-up results of a multicentre, prospective, randomized study. The DISCO trial. DIrect Stenting of COronary Arteries. | | Author(s) | Martínez-Elbal L, Ruiz-Nodar JM, Zueco J, López-Minguez JR, Moreu J, Calvo I, Ramirez JA, Alonso M, Vazquez N, Lezaun R, Rodriguez C | | Institution | Cardiology Department, Hospital Universitario de la Princesa, Madrid, Spain. | | Source | Eur Heart J 2002 Apr; 23(8):633-40. | | MeSH | Adult
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Blood Vessel Prosthesis Implantation
Comparative Study
Coronary Angiography
Coronary Artery Bypass
Coronary Restenosis
Coronary Stenosis
Coronary Vessels
Female
Follow-Up Studies
Humans
Male
Middle Aged
Postoperative Complications
Prospective Studies
Spain
Stents
Survival Analysis
Time Factors
Treatment Outcome
| | Abstract | AIMS: To assess the safety of direct coronary stenting, its influence on costs, duration of the procedure, radiation exposure, clinical outcome and angiographic restenosis.
METHODS AND RESULTS: We randomized 416 patients (446 lesions) to direct stent implant or stent implant following balloon pre-dilation. Patients >75 years old, heavily calcified lesions, bifurcations, total occlusions, left main lesions and very tortuous vessels were excluded. Direct stenting was successful in 217/224 lesions (96.8%). No single loss or embolization of the stent occurred. All stents in the group with pre-dilation were effectively deployed. The immediate post-procedure angiographic results were similar with both techniques. Fluoroscopy and procedural time were significantly lower in direct stenting (6.4+/-0.3 and 21+/-0.9 min) than in pre-dilated stenting (9.1+/-0.4 and 27.5+/-1.1 min) (P>0.001). Major adverse cardiac events during hospitalization were one in direct and four in pre-dilated stenting (P=0.05) but there were no significant differences at follow-ups at 1, 6 and 12 months between the two groups. Angiographic reevaluation at 6 months was performed in 94% of the cases. Restenosis rate was 16.5% in direct stenting and 14.3% in pre-dilated stenting (P=ns).
CONCLUSIONS: Direct stenting is as safe as pre-dilated stenting in selected coronary lesions. Acute angiographic results are similar but procedural costs, duration of the procedure and radiation exposure are lower in direct stenting. Overall success rate, mid-term clinical outcome and restenosis are similar with both techniques. | | Language | eng | | Pub Type(s) | Clinical Trial
Journal Article
Multicenter Study
Randomized Controlled Trial
| | PubMed ID | 11969278 |
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