Safety and Efficacy of Direct Stenting versus Balloon Pre Dilatation in Patients with Chronic Coronary Syndrome

Abstract

Background: Direct stenting (DS) or balloon pre dilatation according to scenarios of cases as in thrombotic lesions where operators usually attempt DS to avoid distal embolization and no-reflow, unless balloon pre-dilation is needed due to inadequate visualization of the distal vessels to deployment the stent In non-calcified , non-complex lesions the operator usually choose direct stent strategy but in lesions with high degree complexity and /or severe calcification usually needed balloon pre-dilatation before stent deployment. Methods: This randomized clinical trial study was conducted on 80 patients in the Cardiovascular Medicine Department of Matria Teaching Hospital (MTH) and Cardiovascular Department, Faculty of Medicine, Benha University. All studied cases were subjected to the following: Detailed history taking, including [Personal history, risk factors, family history, Clinical examination, Laboratory investigations included complete blood count (CBC), Creatinine, urea, and international normalized ratio (INR), Investigations included (12-lead electrocardiogram (ECG), echocardiography Complete comprehensive transthoracic echocardiographic examinations Results: There was an insignificant difference between both groups regarding the outcome at 3 months’ follow-up including recurrent symptoms, myocardial infarction, arrhythmia, and heart failure. Conclusion: Direct stenting was associated with significantly shorter procedural times and a lower volume of contrast compared to the balloon pre-dilatation strategy. There was also a tendency toward lower hemoglobin Hb levels with direct stenting at 3-month follow-up; the clinical relevance of this finding remains unknown, taking into account that there was no significant outcome difference between both strategies.