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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Procedural Efficiency of Direct Stenting Versus Predilatation in Type A and B1 Coronary Lesions

  • Gazi Capar1
  • Ahmet Guler2
  1. 1Department of Cardiology, Istanbul Esenyurt State Hospital, Istanbul 34517, Türkiye
  2. 2Department of Cardiology, Istanbul Basaksehir Cam and Sakura City Hospital, Istanbul 34480, Türkiye
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Abstract

Background/Objectives: The optimal stent deployment strategy for low-complexity Type A and B1 coronary lesions remains poorly defined. We compared direct stenting (DS) and predilatation followed by stenting (PS) in elective percutaneous coronary intervention (PCI) for these lesions. Methods: This single-center, retrospective study included adults undergoing elective PCI with drug-eluting stents for ACC/AHA Type A or B1 lesions between June 2020 and December 2025. Procedure duration, cumulative contrast volume, and cumulative reference air kerma were compared using generalized estimating equations accounting for within-patient clustering, adjusted for clinical, lesion-related, procedural, and operator-related factors. Results: In total, 324 patients contributed 334 PCI observations (PS: 239; DS: 95). After adjustment, DS was associated with lower contrast volume (−18.12 mL; 95% CI −28.08 to −8.17; p < 0.001) and lower cumulative reference air kerma (−223.54 mGy; 95% CI −259.98 to −187.11; p < 0.001), whereas procedure duration did not differ significantly (−0.92 min; 95% CI −4.56 to 2.71; p = 0.619). Findings were consistent when restricted to the first PCI per patient. Conclusions: In these lesions, DS was associated with lower contrast volume and cumulative reference air kerma, without a significant adjusted difference in procedure duration. As nonrandomized observations, these findings do not establish equivalence in clinical safety or effectiveness, nor do they demonstrate cost-effectiveness.

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Cite

BibTeXRIS
BibTeX
@article{capar2026procedural,
  title = {{Procedural Efficiency of Direct Stenting Versus Predilatation in Type A and B1 Coronary Lesions}},
  author = {Gazi Capar and Ahmet Guler},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15208144},
  url = {https://www.mdpi.com/2077-0383/15/20/8144},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Procedural Efficiency of Direct Stenting Versus Predilatation in Type A and B1 Coronary Lesions
AU  - Gazi Capar
AU  - Ahmet Guler
PY  - 2026
DA  - 2026/10/01
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15208144
UR  - https://www.mdpi.com/2077-0383/15/20/8144
AB  - Background/Objectives: The optimal stent deployment strategy for low-complexity Type A and B1 coronary lesions remains poorly defined. We compared direct stenting (DS) and predilatation followed by stenting (PS) in elective percutaneous coronary intervention (PCI) for these lesions. Methods: This single-center, retrospective study included adults undergoing elective PCI with drug-eluting stents for ACC/AHA Type A or B1 lesions between June 2020 and December 2025. Procedure duration, cumulative contrast volume, and cumulative reference air kerma were compared using generalized estimating equations accounting for within-patient clustering, adjusted for clinical, lesion-related, procedural, and operator-related factors. Results: In total, 324 patients contributed 334 PCI observations (PS: 239; DS: 95). After adjustment, DS was associated with lower contrast volume (−18.12 mL; 95% CI −28.08 to −8.17; p < 0.001) and lower cumulative reference air kerma (−223.54 mGy; 95% CI −259.98 to −187.11; p < 0.001), whereas procedure duration did not differ significantly (−0.92 min; 95% CI −4.56 to 2.71; p = 0.619). Findings were consistent when restricted to the first PCI per patient. Conclusions: In these lesions, DS was associated with lower contrast volume and cumulative reference air kerma, without a significant adjusted difference in procedure duration. As nonrandomized observations, these findings do not establish equivalence in clinical safety or effectiveness, nor do they demonstrate cost-effectiveness.
SN  - 2077-0383
ER  -