COMPARISON OF DIRECT STENTING VERSUS PRE-DILATION OUTCOMES IN PRIMARY PCI AT A MAJOR HOSPITAL

Stents are utilized in over 95% of percutaneous coronary interventions (PCIs), and advancements in balloon and stent technologies have fostered the development of direct stent (DS) delivery. This approach, which bypasses pre-dilatation, may offer distinct advantages over conventional stenting (CS), which includes balloon dilation before stenting. Objective: To evaluate the angiographic and short-term clinical outcomes of direct stent placement compared to traditional stenting following balloon dilation in patients undergoing primary percutaneous coronary interventions. Methods: This cross-sectional study was conducted from December 2023 to May 2024 at Hayatabad Medical Complex, Pakistan. One hundred patients undergoing primary PCI were randomly assigned to two groups: Group A (n=50) received direct stent placement, and Group B (n=50) underwent stenting following balloon dilation. Data collection included demographic details, coronary intervention details, and procedural outcomes from medical records. Statistical analyses were performed using SPSS software, with Independent samples t-tests used to compare fluoroscopy times, procedure durations, and contrast usage, considering a P-value < 0.05 as significant. Results: The study enrolled 100 patients, with a mean age of 52.8 ± 11.0 years; 76% were male. The most commonly treated vessel was the left anterior descending artery. Group A demonstrated a significantly shorter fluoroscopy time (4.6 ± 2.9 minutes vs. 6.9 ± 4.1 minutes, P=0.001) and total procedure duration (24.4 ± 12.4 minutes vs. 34.6 ± 13.5 minutes, P=0.008) compared to Group B. Furthermore, Group A used less contrast material than Group B. Conclusion: Direct stenting offers a safer, quicker, and more cost-effective alternative to conventional stenting with balloon dilation in primary PCI. This method reduces radiation exposure, procedural costs, and operational time, potentially enhancing outcomes for patients and healthcare teams.