Coronary stenting without predilatation (SWOP): applicable technique in everyday practice.

Area of Science:

• Interventional Cardiology
• Cardiovascular Interventions
• Medical Device Technology

Background:

• Coronary artery interventions commonly involve balloon angioplasty and stenting.
• Predilatation is a standard step in many stenting procedures.
• Evaluating alternative strategies like stenting without predilatation is crucial for optimizing patient care and resource utilization.

Purpose of the Study:

• To assess the feasibility and procedural success of stenting without predilatation (SWOP) compared to other interventional strategies.
• To determine the proportion of lesions suitable for SWOP.
• To evaluate the cost-effectiveness implications of SWOP.

Main Methods:

• A prospective registration of 684 interventional procedures across 600 patients over a 6-month period.
• Interventions were categorized into four groups: SWOP, primary stenting with predilatation (PDS), provisional stenting (PRS), and plain-old balloon angioplasty (POBA).
• Interventional strategy selection was based on operator discretion, angiographic criteria, and clinical judgment.

Main Results:

• SWOP was utilized in 32.4% of lesions (221/684).
• Procedural success rates were comparable across all stenting groups (SWOP, PDS, PRS).
• Approximately 60% of lesions planned for primary stenting were effectively treated with SWOP.

Conclusions:

• Stenting without predilatation (SWOP) is a viable and effective strategy for a significant proportion of coronary lesions.
• SWOP demonstrates excellent procedural results, comparable to predilatation techniques.
• Implementing SWOP when primary stenting is indicated can lead to considerable cost savings in interventional cardiology procedures.