Comparing the post procedural corrected timi frame count in direct stenting versus conventional stenting (Stenting after PTCA) in patients who had undergone percutaneous coronary interventions

Aim of the study: Percutaneous Coronary Interventions (PCI) are more frequently used at the treatment of coronary artery disease. Some centers use `direct stenting? as an alternative prosedure to `stenting after balloon predilatation?. TIMI frame count is a parameter for the evaluation of antegrade coronary blood flow. In a small trial of patients with STEMI, it has been shown that `direct stenting? decrease the post PCI mean cTIMI frame count, but there is no evidence in stable coronary artery disease. The aim of our study is to compare the effect of `direct stenting? and `stenting after balloon predilatation? , on the antegrad coronary blood flow by using TIMI frame count in patients with stable coronary artery disease.Methods: Among patients who had undergone `direct stenting? or `stenting after balloon predilatation? between January 2008 and December 2011, 97 patients were enrolled in the study by screening retrospectively (55 patients in `direct stenting? group and 42 patients in `stenting after balloon predilatation? group). Patients? medical and demographic data were taken from our hospital?s medical history records. Coronary angiography and PCI images (recorded on CDs at the coronary angiography unit) were reviewed. Than , pre and post PCI TIMI frame counts and corrected TIMI frame counts (cTIMI) were calculated for all patients. Groups were compared regarding their pre and post PCI cTIMI frame counts.Results: In `direct stenting? group, pre PCI mean cTIMI frame count was 18,7 fps and the post PCI mean cTIMI frame count was 16,1 fps. On the other hand, in `stenting after balloon predilatation? group pre PCI mean cTIMI frame count was 18,1 fps and the post PCI mean cTIMI frame count was 16,6 fps. Tthe difference between post PCI mean cTIMI frame count and pre PCI mean cTIMI frame count was 2,6 fps in `direct stenting? group. In contrast this difference was only 1,4 fps for `stenting after balloon predilatation? group. The change of cTIMI frame count between two groups was found statistically significant (p< 0,001).Conclusion: Our data showed that `direct stenting? procedure leads to a statistically significant decrease in the post PCI mean cTIMI frame count. So that , `direct stenting? could result in a better antegrade coronary blood flow comparing the `stenting after balloon predilatation? procedure.