Comparision between Direct Stenting and Stenting after Pre-dilatation Using TIMI Frame Count in Stable Coronary Artery Disease

Abstract

Introduction: There are limited data comparing the effects of direct stenting and stenting after balloon percutaneous transluminal coronary angioplasty (PTCA) on coronary flow in patients with stable coronary artery disease (CAD). This study was designed to evaluate the effects of direct stenting and stenting after balloon PTCA on coronary flow using TIMI frame count (TFC) in patients with stable CAD. Patients and Methods: After a retrospective review of patients who underwent percutaneous coronary intervention (PCI) from 2008 to 2012, we identified and included 55 patients who underwent direct stenting and 42 patients who received stenting after balloon PTCA. PCI records of the two study groups were reviewed to re-calculate pre- and post-PCI TFCs for comparison. Results: The average pre- and post-procedural TFC values were 18.72 frames per second (fps) and 16.12 fps (difference 2.6 fps), respectively, in the direct stenting group. The corresponding TFC values were 18.13 fps and 16.63 fps (difference 1.5 fps) in the stenting after balloon PTCA group. The two groups differed significantly with respect to post-procedural decreases in TFC (p< 0.001). Conclusion: Our findings show that, compared to stenting after balloon PTCA, direct stenting is more successful in terms of improved antegrade coronary blood flow in stable CAD patients, which suggests that direct stenting may contribute to better microvascular circulation.