Randomized comparison of direct and provisional stenting in de novo coronary artery lesions: the RADICAL study.

Background: Although preliminary reports have demonstrated excellent primary success and improved economics with direct stenting, a clinically relevant reduction of restenosis rate has not been documented yet.

Aims: Aims of the study were the comparison of restenosis rate (primary endpoint), procedural success, fluoroscopy time, amount of contrast dye and clinical outcome (secondary endpoints).

Methods And Results: Between January and December 1999, 250 patients were randomly assigned either to direct stent implantation without predilatation (DS; 125 patients) or provisional stenting (PB; 125 patients) and followed for 7.

Immediate and late effects of coronary angiography on soluble endothelial cell markers and P-selectin in patients with and without coronary artery disease.

Endothelial cell injury and platelet activation are considered primary events in the pathogenesis of coronary artery disease (CAD) and are marked by plasma concentrations of von Willebrand factor (vWF) and soluble thrombomodulin, and by soluble P-selectin, respectively. Because both endothelial cells and platelets interact with contrast media, we aimed to detect immediate and 24-h changes in these markers following coronary angiography in patients with and without CAD. Sixteen patients with angiographically proven CAD and 14 patients without significant coronary stenosis were investigated.