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Heart 2001;86:302-308; doi:10.1136/heart.86.3.302
Copyright © 2001 BMJ Publishing Group Ltd & British Cardiovascular Society
Heart 2001;86:302-308 ( September )

Interventional cardiology surgery

Randomised comparison of coronary stenting with and without balloon predilatation in selected patients H Le Bretona, J Boschatb, P Commeauc, P Bruneld, M Gilardb, C Breute, O Barf, P Gesling, A Tirouvanziamh, L Maillardi, B Moquetj, P Barragank, P Dupouyl, G Grollierm, J Berlandn, P Druelleso, R Rihanip, B Huretc, C Leclercqa, M Bedossaa, for the Stent Without Balloon Predilation (SWIBAP) Study Group

a Centre Cardio- Pneumologique, Unité d'hémodynamique et de Cardiologie interventionnelle, CHU Pontchaillou, Rue Henri Le Guilloux, 35033 Rennes cedex, France, b Centre Hospitalier Universitaire la Cavale Blanche, Brest, c Clinique St Martin, Caen, d Nouvelles Cliniques Nantaises---St Henri, Nantes, e Clinique du Grand Large, Brest, f Clinique St Gatien, Tours, g Centre Hospitalier Universitaire, Angers, h Centre Hospitalier Universitaire, Nantes, i Centre Hospitalier Universitaire, Tours, j Clinique de la Reine Blanche, Orléans, k Centre Hospitalier Beauregard, Marseille, l Centre Hospitalier Universitaire Henri Mondor AP-HP, Creteil, m Centre Hospitalier Universitaire, Caen, n Clinique St Hilaire, Rouen, o Clinique St Laurent, Rennes, p Centre Hospitalier St Philibert, Lomme

Correspondence to: Professor Le Breton herve.lebreton{at}chu-rennes.fr

Accepted 15 May 2001

BACKGROUND---The SWIBAP (stent without balloon predilatation) prospective randomised trial was designed to compare direct coronary stenting with stenting preceded by lesion predilatation with an angioplasty balloon.
OBJECTIVE---To determine the feasibility and safety of direct stenting in non-complex coronary lesions in a prospective study.
PATIENTS AND DESIGN---All patients < 76 years of age scheduled to undergo angioplasty of a non-complex, non-calcified lesion in a coronary artery of > 3.0 mm, who granted their informed consent, were randomised into the trial. In group I, the stent was placed without balloon predilatation, while in group II stent implantation was preceded by balloon predilatation. The primary end point was the angiographic result according to procedure assigned by randomisation. An intravascular ultrasound substudy was performed in 60 patients.
RESULTS---Stent implantation was successful without predilatation in 192 of the 197 group I patients (97.5%), and with predilatation in 197 of the 199 group II patients (99%) (NS). No in-hospital stent thrombosis or death occurred. Overall procedural times, fluoroscopy times, and volumes of contrast agent given (mean (SD)) in group I v group II were 23.50 (13.54) min v 27.96 (15.23) min (p = 0.002), 6.04 (4.13) min v 6.67 (3.65) min (NS), and 135 (65) ml v 157 (62) ml (p < 0.001), respectively. No major adverse cardiovascular events had occurred by 30 days.
CONCLUSIONS---The feasibility and safety of direct stenting of selected and non-complex coronary lesions is confirmed. This technique was as successful as the conventional approach and was associated with a minor reduction in fluoroscopic exposure and procedure time and the administration of less contrast agent.


Keywords: coronary artery angioplasty; stent; coronary artery ultrasound

© 2001 by Heart
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