TY  - JOUR
T1  - Comparision between Direct Stenting and Stenting after Pre-dilatation Using TIMI Frame Count in Stable Coronary Artery Disease
TT  - Stabil Koroner Arter Hastalığında Doğrudan Stentleme ve Ön-dilatasyon Sonrası Stentleme Yöntemlerinin TIMI Kare Sayısı Kullanılarak Karşılaştırılması
AU  - Eyüboğlu, Mehmet
AU  - Akdeniz, Bahri
AU  - Şenarslan, Ömer
AU  - Ekinci, Mehmet Akif
AU  - Arslan, Abdurrahman
AU  - Aytemiz, Fatih
AU  - Koyuncu, İlhan
AU  - Ünal, Barış
AU  - Koyuncu, Betül
PY  - 2015
DA  - December
JF  - Koşuyolu Heart Journal
PB  - Kartal Koşuyolu Yüksek İhtisas EAH
WT  - DergiPark
SN  - 2149-2972
SP  - 130
EP  - 134
VL  - 18
IS  - 3
LA  - en
AB  - Introduction:There are limited data comparing the effects ofdirect stenting and stenting after balloon percutaneous transluminal coronaryangioplasty (PTCA) on coronary flow in patients with stable coronary artery disease(CAD). This study was designed to evaluate the effects of direct stenting andstenting after balloon PTCA on coronary flow using TIMI frame count (TFC) inpatients with stable CAD.Patientsand Methods: After a retrospective review of patients who underwentpercutaneous coronary intervention (PCI) from 2008 to 2012, we identified andincluded 55 patients who underwent direct stenting and 42 patients who receivedstenting after balloon PTCA. PCI records of the two study groups were reviewedto re-calculate pre- and post-PCI TFCs for comparison.Results:The average pre- and post-procedural TFC valueswere 18.72 frames per second (fps) and 16.12 fps (difference 2.6 fps),respectively, in the direct stenting group. The corresponding TFC values were18.13 fps and 16.63 fps (difference 1.5 fps) in the stenting after balloon PTCAgroup. The two groups differed significantly with respect to post-proceduraldecreases in TFC (p< 0.001).Conclusion:Our findings show that, compared to stenting afterballoon PTCA, direct stenting is more successful in terms of improved antegradecoronary blood flow in stable CAD patients, which suggests that direct stentingmay contribute to better microvascular circulation.
KW  - Percutaneous coronary intervention
KW  - angioplasty
KW  - direct stenting
N2  - Giriş:Stabil koroner arter hastalığında doğrudan stent veperkütan translüminal koroner anjiyoplasti (PTKA) sonrasında stentlemeyöntemlerinin koroner kan akımı üzerine etkisini karşılaştıran yeterli veriyoktur. Çalışmamızda, doğrudan stent ve PTKA sonrası stentleme yöntemlerininkoroner kan akımı üzerine etkisi TIMI kare sayısı (TKS) kullanılarakkarşılaştırıldı.Hastalarve Yöntem: 2008-2012 yılları arasındaperkütan koroner girişim (PKG) yapılan hastalar taranarak, doğrudan stentlemeuygulanmış 55 hasta ve PTKA sonrası stentleme uygulanmış 42 hasta çalışmayaalındı. Hastaların PKG kayıtları izlendi. Her hasta için işlem öncesi vesonrası TKS hesaplandı. İki tedavi grubu işlem öncesi ve sonrası TKS açısındankarşılaştırıldı.Bulgular:Doğrudan stent grubunda ortalama TKS işlemöncesinde 18.72 kare/saniye, işlem sonrasında 16.12 kare (fark 2.6 kare/saniye)bulundu; PTKA sonrası stent grubunda ise bu değerler sırasıyla 18.13kare/saniye ve 16.63 kare/saniye (fark 1.5 kare/saniye) idi. İşlem sonrasıTKS’deki azalma açısından iki grup arasındaki fark anlamlı idi (p< 0.001).Sonuç: Bulgularımız, stabil koroner arterhastalığında doğrudan stentleme yönteminin koroner kan akımını iyileştirmedePTKA sonrası stentlemeye göre daha başarılı olduğunu gösterdi. Bu bulgu,doğrudan stentleme ile daha iyi mikrovasküler dolaşım sağlandığını düşündürmektedir.
CR  - 1.	Martinez-Elbal L, Ruiz-Nodar JM, Zueco J, López-Minguez JR, Moreu J, Calvo I, et al. Direct coronary stenting versus stenting with balloon pre-dilation: immediate and follow-up results of a multicentre, prospective, randomized study. The DISCO trial. Direct stenting of coronary arteries. Eur Heart J 2002;23:633-40.
CR  - 2.	Weber F, Schneider H, Warzok F, Petzsch M, von Knorre GH, Nienaber CA. Randomized comparison of direct and provisional stenting in de novo coronary artery lesions: the RADICAL study. Z Kardiol 2003;92:173-81.
CR  - 3.	Özdemir R, Sezgin AT, Barutcu I, Topal E, Güllü H, Açıkgöz N. Comparison of direct stenting versus conventional stent implantation on blood flow in patients with ST-segment elevation myocardial infarction. Angiology 2006;57:453-8.
CR  - 4.	Gibson CM, Cannon CP, Daley WL, Dodge JT Jr, Alexander B Jr, Marble SJ, et al. TIMI frame count: a quantitative method of assessing coronary artery flow. Circulation 1996;93:879-88.
CR  - 5.	Rogers C, Karnovsky MJ, Edelman ER. Inhibition of experimental neointimal hyperplasia and thrombosis depends on the type of vascular injury and the site of drug administration. Circulation 1993;88:1215-21.
CR  - 6.	Schwartz  RS,  Huber  KC,  Murphy  JG,  Edwards  WD,  Camrud  AR,  Vlietstra  RE,  et  al. Restenosis and the proportional neointimal response to coronary artery injury: results in a porcine model. J Am Coll Cardiol 1992;19:267-74.
CR  - 7.	Alidoosti M, Salarifar M, Kassaian SE, Zeinali AM, Fathollahi MS, Dehkordi MR. In-hospital and mid-term adverse clinical outcomes of a direct stenting strategy versus stenting after predilatation for the treatment of coronary artery lesions. Cardiovasc J Afr 2008;19:297-302.
CR  - 8.	Baim DS, Flatley M, Caputo R, O’Shaughnessy C, Low R, Fanelli C, et al. Comparison of PRE-dilatation  vs  direct  stenting  in  coronary  treatment  using  the  Medtronic  AVE  S670 Coronary Stent System (The PREDICT trial). Am J Cardiol 2001;88:1364-9.
CR  - 9.	Danzi GB, Capuano C, Fiocca L, Dallavalle F, Pirelli S, Mauri L, et al. Stent implantation without predilation in patients with a single, noncalcified coronary artery lesion. Am J Cardiol 1999;84:1250-3.
CR  - 10.	Le Breton H, Boschat J, Commeau P, Brunel P, Gilard M, Breut C, et al. Randomized comparison of coronary stenting with and without balloon predilatation in selected patients. Heart 2001;86:302-8.
CR  - 11.	Balachandran KP, Singh B, Sandilands A, Popusoi G, Rubino P, Baumbach A. Functional result following direct coronary artery stenting with drug eluting stents in chronic stable angina is similar to stenting after balloon predilatation. Int J Cardiol 2008;128:374-7.
CR  - 12. 	Balducelli  M,  Varani  E,  Vecchi  G,  Paloscia  L,  Manari A,  Santarelli A,  et  al. Direct coronary stenting versus stenting with balloon pre-dilation: incidence of enzyme release and follow-up results of a multicentre, prospective, randomized study. The CK and  Troponin  I  Estimation  in  direct  STenting  (CK  TEST)  trial.  Minerva  Cardioangiol 2007;55:281-9.
UR  - https://dergipark.org.tr/en/pub/khj/issue//499851
L1  - https://dergipark.org.tr/en/download/article-file/601780
ER  -