Direct Stenting for Stable Angina Pectoris Is Associated With Reduced Periprocedural Microcirculatory Injury Compared With Stenting After Pre-Dilation

Direct Stenting for Stable Angina Pectoris Is Associated With Reduced Periprocedural Microcirculatory Injury Compared With Stenting After Pre-Dilation Thomas Cuisset, Michalis Hamilos, Narbeh Melikian, Eric Wyffels, Jaydeep Sarma, Giovanna Sarno, Emanuele Barbato, Jozef Bartunek, William Wijns, Bernard De Bruyne Direct stenting (DS) has been suggested to reduce periprocedural microcirculatory injury compared with stenting that follows pre-dilation. We conducted a randomized study to compare the effect of DS and conventional stenting (CS) on the post-procedural index of microcirculatory resistance and troponin T values after elective percutaneous coronary intervention (PCI). Patients undergoing DS had lower index of microcirculatory resistance values (DS 13 ± 3, CS 24 ± 14; p < 0.01) and tended to have lower post-PCI troponin T values (DS 0.035 ± 0.04, CS 0.17 ± 0.02; p = 0.07). In conclusion, for patients undergoing coronary stenting for stable angina, DS is associated with reduced microvascular impairment induced by PCI as compared with CS.