Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Cardiac Catheterization I: Pre-Procedure Overview01:28

Cardiac Catheterization I: Pre-Procedure Overview

Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
Coronary Artery Disease IV: Preventive Measures01:26

Coronary Artery Disease IV: Preventive Measures

Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Risk Factors of Small for Gestational Age Babies Born at Term Gestation.

Kathmandu University medical journal (KUMJ)·2026
Same author

Simple Oncoplastic Breast Conserving Surgery for Breast Cancer in a University Hospital.

Kathmandu University medical journal (KUMJ)·2024
Same author

Alarm Fatigue among Nurses Working in Critical Care Setting in a Tertiary Hospital, Nepal.

Kathmandu University medical journal (KUMJ)·2023
Same author

Round Block Technique in Management of Breast Lesions.

Kathmandu University medical journal (KUMJ)·2020
Same author

Extended Spectrum β-lactamase (ESBL) Producing Multi Drug Resistant (MDR) Urinary Pathogens in a Children Hospital from Nepal.

Kathmandu University medical journal (KUMJ)·2019
Same author

Self-Perception of Halitosis among Undergraduate Students of Kathmandu University School of Medical Sciences - A Questionnaire Based Study.

Kathmandu University medical journal (KUMJ)·2019

Related Experiment Video

Updated: Jul 15, 2026

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
04:30

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

Provisional versus routine coronary stenting. A review.

S Khanal1, W D Weaver

  • 1Henry Ford Heart and Vascular Institute, Detroit, Michigan, USA.

Minerva Cardioangiologica
|December 6, 2001
PubMed
Summary

This review compares two approaches to coronary stenting: routine stenting, where all stentable lesions are treated with stents, and provisional stenting, where stents are used only when balloon angioplasty fails. Retrospective studies suggested similar outcomes with provisional stenting, but prospective trials found better results with routine stenting. The review also examined whether techniques like coronary flow reserve or intravascular ultrasound could improve provisional stenting outcomes. Over half of balloon angioplasty cases still required stents. Economic analysis showed no cost advantage for provisional stenting. The authors suggest routine stenting is more justifiable with current angiography guidance. Future developments like drug-coated stents may further support routine stenting.

Keywords:
coronary stentingangioplasty outcomesinterventional cardiologyvascular revascularization

Frequently Asked Questions

More Related Videos

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
05:25

Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft

Published on: September 15, 2023

Related Experiment Videos

Last Updated: Jul 15, 2026

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
04:30

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
05:25

Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft

Published on: September 15, 2023

Area of Science:

  • Cardiovascular interventions in interventional cardiology
  • Medical device outcomes research in clinical cardiology

Background:

Coronary stenting is widely adopted for revascularization due to its predictable outcomes in specific lesion types. Prior research has shown balloon angioplasty alone has suboptimal results in many cases. This gap motivated evaluating alternative strategies. Established knowledge includes the safety and efficacy of stents in certain coronary lesions. No prior work had resolved whether all stentable lesions should be routinely stented. Theoretical advantages of provisional stenting include reduced device use and cost. However, the evidence base is mixed between retrospective and prospective studies. This uncertainty drives the need for a synthesis of current findings.

Purpose Of The Study:

This review aims to compare provisional and routine coronary stenting strategies. The specific problem is whether all stentable lesions should be stented. The motivation comes from conflicting evidence between retrospective and prospective studies. Retrospective data suggested similar outcomes with provisional stenting. Prospective studies, however, suggest routine stenting may be superior. The goal is to synthesize findings to guide clinical practice. The review focuses on angiography-guided provisional stenting. It also considers alternative imaging techniques like intravascular ultrasound.

Main Methods:

The review synthesizes retrospective and prospective studies comparing stenting strategies. Retrospective data included vessel recoil after balloon angioplasty. Prospective randomized trials used angiography to guide provisional stenting. Comparative analysis focused on target revascularization rates. The review also considered economic implications of each strategy. Alternative imaging techniques were evaluated for guiding stenting. Outcomes were measured using angiographic success and revascularization rates. The authors analyzed whether coronary flow reserve or ultrasound could improve provisional stenting.

Main Results:

Retrospective studies suggested similar revascularization rates with provisional stenting. Prospective randomized trials found better outcomes with routine stenting. Angiography-guided provisional stenting did not match routine stenting results. Over half of the balloon angioplasty group required stenting. Economic analysis showed no cost advantage for provisional stenting. Coronary flow reserve or ultrasound may improve provisional stenting outcomes. Routine stenting remains more justifiable with current angiography guidance. Further stent technology advancements may enhance routine stenting benefits.

Conclusions:

The authors suggest routine stenting is more justifiable with current angiography guidance. They propose that provisional stenting needs alternative imaging to match routine results. No prior work had resolved the economic implications of each strategy. The review highlights that over half of balloon angioplasty cases still require stents. Routine stenting may become even more attractive with drug-coated stents. The findings are based on prospective randomized trials and economic analyses. The authors do not claim routine stenting is essential for all cases. They suggest further research on imaging-guided provisional stenting.

Provisional stenting uses stents only when balloon angioplasty fails, while routine stenting applies stents to all stentable lesions.

The authors suggest coronary flow reserve or intravascular ultrasound may improve provisional stenting outcomes.

Prospective studies suggest angiography-guided provisional stenting has worse outcomes than routine stenting.

Routine stenting is not more cost-effective than provisional stenting, even with higher stent use.

Over half of balloon angioplasty cases still require stenting, according to the review findings.

The authors suggest drug-coated stents may make routine stenting even more attractive.