Direct stenting application in acute coronary syndromes

Abstract

Although published reports of direct stenting to treat stable coronary artery disease have been increasing,the number of studies regarding direct stenting for acute coronary syndrome is limited. In this study, we report immediate and mid-term results for patients who underwent direct stenting to treat acute coronary syndrome. The average lesion length was 12.1 mm +/-3.3 mm. The preprocedure average MLD was 0.67 mm +/-0.33 mm. Post-procedure average MLD was 3.19 mm +/-0.42 mm. In 35 of the 36 cases,the stent delivery system crossed the lesion and was implanted successfully. In one case, an acute occlusion occurred,which was treated by PTCA. In 97 percent of cases, the lesion was crossed success-fully, and the procedure success rate was 94 percent. The amount of contrast media used was 88 ml +/-16 ml. The duration of radiation exposure was 9 min +/-2 min. Control angiography was performed in 28 out of 35 cases (80 percent). The seven patients who did not consent to coronary angiography were asymptomatic and had negative exercise tests.MLD at six-month follow-up was 2.66 mm +/-0.53 mm. The clinical restenosis rate was 14 percent (5/35), and the angiographic restenosis rate was 18 percent (5/28). Three of the five cases of restenosis were treated by ELCA and PTCA; the other two cases were treated with PTCA only. Target lesion revascularization rate was 14 percent (5/35). Six-month MACE was 17 percent (6/35). Based on these results, we conclude that direct stenting for acute coronary syndrome is safe if the lesion is determined to be suitable.