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Coronary stenting with premounted stents without predilation is feasible and safe in selected patients in order to reduce fluoroscopic and procedural time and to save costs. Furthermore, this procedure might reduce the risk of hazardous coronary dissections.

Out of a total of 1640 consecutive left heart catheterizations, 70 (58 males and 12 females; mean age 56 +/- 8 years) were performed via the right brachial artery, in most instances because of occlusive disease of the arteries in the pelvic region. 5F catheters were then successfully used for both the coronary and left-ventricular angiographies. Noninvasive examinations after two days (Doppler ultrasound, oscillography at rest and on exercise, acral plethysmography and colour-coded duplex sonography) revealed small haematomas in the region of the arterial puncture in four and a haemodynamically insignificant fistula between brachial artery and vein in one patient but no aneurysm, stenosis or thrombosis at the puncture site. This procedure is thus a valuable addition to invasive cardiological diagnosis.

We report a 64‐year‐old patient with single vessel coronary disease who initially underwent PTCA and stent implantation for a complex RCA lesion. The patient was subsequently readmitted for unstable angina pectoris after 2 and 6 months. Coronary angiograms each time revealed subtotal reocclusions of the target vessel due to in‐stent restenosis. At 2 months, the patient underwent rotational atherectomy and additional stent implantation, During the second reintervention at 6 months rotational atherectomy was followed by implantation of two membrane‐covered stent deployed within the conventional stents (stent‐indent). Subsequently, the patient remained asymptomatic. Control angiography after 5 months revealed only minor stent lumen loss not requiring reintervention. Membrane‐covered stents appear to be a promising alternative to reduce the incidence and degree of in‐stent restenosis in selected lesions.