Comparison of outcomes (early and six- month) of direct stenting with conventional stenting (a meta-analysis of ten randomized trials)

The independent value of a direct stenting strategy on early and late clinical outcomes in patients undergoing elective percutaneous coronary intervention

“…These results are in accordance to previous studies reporting that DS fails to reduce the rate of restenosis [4,22,23] as it had been initially postulated by preclinical and observational studies [6,14,24]. Our findings regarding other late clinical outcomes, such as MACE and ST, are also supported by the existing literature [3][4][5]25]. In reference to early clinical events, the incidence of PPMI was specifically evaluated in this study given a proposed reduction with the use of DS and an established association with worsened in-hospital and longterm outcomes [26][27][28].…”

“…2. These results are in accordance to previous studies reporting that DS fails to reduce the rate of restenosis [4,22,23] as it had been initially postulated by preclinical and observational studies [6,14,24]. Our findings regarding other late clinical outcomes, such as MACE and ST, are also supported by the existing literature [3][4][5]25].…”

“…Although randomized trials have shown similar late clinical outcomes for DS [3][4][5], a higher incidence of stent edge restenosis with PD is proposed and is explained by geographical miss and uncovered balloon injury outside the stent edges [6,7]. Likewise, differences in early clinical events, such as the incidence of periprocedural myocardial injury (PPMI) [6,[7][8][9][10] and the frequency of no-reflow phenomenon [11][12][13], are anticipated to occur less frequently with DS, which is attributed to less wall damage [14,15] and a reduction in particle embolization [3,4,15] when PD is avoided.…”

“…The use of direct stenting (DS) (stent deployment without preparatory balloon dilatation) has been determined to be safe [1,2] and is associated with comparable results to a conventional strategy of stent placement preceded by balloon predilatation (PD) [3][4][5]. With improved device profile and deliverability in newergeneration stents, contemporary interventional cardiologists are more frequently awarded the opportunity to utilize DS.…”

“…Likewise, differences in early clinical events, such as the incidence of periprocedural myocardial injury (PPMI) [6,[7][8][9][10] and the frequency of no-reflow phenomenon [11][12][13], are anticipated to occur less frequently with DS, which is attributed to less wall damage [14,15] and a reduction in particle embolization [3,4,15] when PD is avoided.…”