[Direct Stenting without Predilation: a Single-Center Experience with 1,000 Lesions]

Area of Science:

• Cardiovascular Interventions
• Interventional Cardiology
• Medical Device Technology

Background:

• Direct stenting offers advantages over traditional methods, including reduced costs, procedure time, radiation exposure, and contrast agent usage.
• Evaluating the real-world application of direct stenting is crucial for understanding its practical benefits and limitations.

Purpose of the Study:

• To analyze the outcomes and safety of direct stenting in a large cohort of patients undergoing percutaneous coronary interventions.
• To identify factors associated with the failure of direct stenting and assess complication rates.

Main Methods:

• Retrospective analysis of 1,000 consecutive lesions treated with direct stenting.
• Assessment of primary success, dissection, need for post-dilation, embolism, stent loss, and side branch occlusion.
• Evaluation of patient demographics and lesion characteristics, including thrombus, calcification, and vessel anatomy.

Main Results:

• A primary success rate of 93.1% was achieved in 1,000 direct stenting procedures.
• Complications included dissection (requiring additional stenting in 40 lesions) and thrombus embolism (7 cases).
• Factors associated with direct stenting failure included circumflex artery location (38%), calcification (26%), angulation (22%), and tortuosity (31%).

Conclusions:

• Direct stenting is a safe and feasible technique in routine clinical practice.
• The procedure demonstrates a low incidence of dissection, need for post-dilation, and embolic events.
• Careful patient and lesion selection can optimize outcomes for direct stenting procedures.