Deflated Balloon-Facilitated Direct Stenting in Primary Angioplasty (The DBDS Technique): A Pilot Study

Abstract

Background: Several studies and meta-analyses have shown that direct stenting (DS) may improve clinical outcomes in patients with acute ST-elevation myocardial infarction (STEMI). But in most cases, the thrombolysis in myocardial infarction (TIMI) flow remains < 0.001). DS group had significantly lower procedure time (33 +/- 19 min versus 41 +/- 17 min, P < 0.001), fluoroscopy time (6.2 +/- 3.4 min versus 7.8 +/- 32 min, P < 0.001), required lesser contrast volume (112 +/- 16 mL versus 123 +/- 18 mL, P < 0.001) and had lower procedural cost (310 +/- 45$ versus 402 +/- 56$, P < 0.001). ST-segment resolution > 50% after percutaneous coronary intervention (PCI) were significantly higher in the DS group (85.7% versus 71.1%, P < 0.001). At 30 days, the major adverse cardiac event (MACE) rate was significantly lower in the DS group (2.4% versus 9.3%, P = 0.02), mainly driven by lower rates of target lesion revascularization (TLR) (0.9% versus 4.2%, P = 0.01). Conclusion: This cost-effective technique appears to be simple, feasible and safe and is associated with superior clinical outcomes. It helps in maximizing DS and could offer an alternative to PD and aspiration thrombectomy in total occlusion. However, larger studies with longer follow up are required before a wider application of this technique.