Conventional stenting requires predilatation which potentially increases vessel wall injury and cost of the procedure. In this study, the safety and efficacy of direct Jostent Flex (Jomed AB, Helsingborg, Sweden) stent placement was evaluated in 50 patients. Quantitative coronary angiography was performed at baseline, post-stent and 6 months follow-up. Clinical follow-up was done up to 9 months. In 50 patients (38 male/12 female; age 61+/-12 years) with stable (n = 42; 84%) or unstable (n = 8; 16%) angina, 53 Jostent Flex (JF) stents (diameter 3.2+/-0.2 mm) were implanted for 51 stenoses. Direct stenting was successful in 46 stenoses (90%). No stents were lost or damaged when retrieved after unsuccessful direct delivery. Eventually, all stents could be implanted at the target site. Angiographic success (<30% residual stenosis) was achieved in 49 lesions (96%). At 9 months, none of the patients had died. Target lesion revascularization was necessary in 4 (8%) patients at 6 months and in 2 (4%) other patients between 6 and 9 months. Minimal lumen diameter increased from 1.1+/-0.4 to 2.6+/-0.4 mm (p<0.001) after stent placement and 1.8+/-0.6 mm (p<0.001) at 6 months follow-up. Angiographic restenosis (> 50%) at 6 months was present in 24% of 49 treated stenoses. At 6 and 9 months, 39 (78%) and 41 (82%) of the patients were free of anginal symptoms and the ischemic event-free survival was 80% at 9 months. This study demonstrates the safety and efficacy of direct placement of the JF stent as well as favorable clinical and angiographic results up to 9 months after the procedure.