Multicenter randomized comparison of direct vs. conventional stenting: The DIRECTO trial

With conventional stenting, predilatation frequently induces dissections that require deploying stents longer than originally planned. To assess whether direct stenting is safe and may prevent dissections and reduce the length of stents implanted, we conducted a randomized study comparing direct (n...

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Published in:Catheterization and cardiovascular interventions 2003-04, Vol.58 (4), p.434-440
Main Authors: Ballarino, Miguel A., Moreyra Jr, Eduardo, Damonte, Aníbal, Sampaolesi, Alberto, Woodfield, Scott, Pacheco, Guillermo, Caballero, Gustavo, Picabea, Eduardo, Baccaro, Jorge, Tapia, Luis, Lascano, Esteban Ruiz
Format: Article
Language:English
Subjects:
Aged
angioplasty
Angioplasty, Balloon, Coronary - adverse effects
Angioplasty, Balloon, Coronary - methods
Biological and medical sciences
Catheterization - adverse effects
Catheterization - methods
Confidence Intervals
Coronary Angiography
Coronary Disease - diagnostic imaging
Coronary Disease - therapy
Coronary Restenosis - physiopathology
Diseases of the cardiovascular system
Female
Follow-Up Studies
Humans
Length of Stay
Male
Medical sciences
Middle Aged
Probability
Prospective Studies
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Risk Assessment
Sensitivity and Specificity
Severity of Illness Index
Stents
Treatment Outcome
Vascular Patency
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Summary:With conventional stenting, predilatation frequently induces dissections that require deploying stents longer than originally planned. To assess whether direct stenting is safe and may prevent dissections and reduce the length of stents implanted, we conducted a randomized study comparing direct (n = 73) and conventional (n = 78) stenting. Direct stenting was successful in 89% of cases, 11% crossed over to predilation without complications. Dissections occurred more frequently in conventional stenting group (10.3% vs. 1.4%; P = 0.034), but did not translate to a significant stent length difference (16.31 ± 7.6 vs. 15.31 ± 5.5; P = NS). Periprocedure creatine kinase elevation and number of balloons utilized were lower with direct stenting. Cathet Cardiovasc Intervent 2003;58:434–440. © 2003 Wiley‐Liss, Inc.
ISSN:1522-1946
1522-726X
DOI:10.1002/ccd.10404