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Abstract

Introduction: Percutaneous coronary intervention (PCI) is a standard treatment of coronary artery disease. Direct stenting versus pre-dilation is still a matter of clinical concern, particularly regarding the efficiency of the procedure and outcomes. Objective: To compare the clinical outcomes, safety, and procedural efficiency of direct stenting versus pre-dilation in patients undergoing PCI. Materials and Method: This was a prospective observational study conducted at Department of Interventional Adult Cardiology, Sheikh Mohamed Bin Zayed Al Nahyan (SMBZAN) Institute of Cardiology Quetta, from 15th December, 2024 to 15th June, 2025. Two hundred patients undergoing PCI were randomly assigned to two groups direct stenting and pre-dilation. The baseline data, procedural factors, and 30-day outcomes were collected and analyzed. Findings: Direct stenting resulted in a lower contrast volume, a considerable reduction in procedure time, and a shorter fluoroscopy duration. The incidence of major adverse cardiac events was comparable between the two groups, but the minor vascular adverse events were less in the direct stenting group. Conclusion: Direct stenting is safe and an efficient procedure, which is an alternative to pre-dilation among properly identified PCI patients.