Usefulness of Coronary Pressure Measurement for Functional Evaluation of Drug-Eluting Stent Restenosis

Authors
Chang-Wook NamSeung-Woon RhaBon-Kwon KooJoon-Hyung DohWoo-Young ChungMyeong-Ho YoonSeung-Jea TahkBong-Ki LeeJin-Bae LeeKi-Dong YooYun-Kyeong ChoIn-Sung ChungSeung-Ho HurKwon-Bae KimCheol Ung ChoiDong Joo Oh
Department
Dept. of Internal Medicine (내과학); Dept. of Preventive Medicine (예방의학)
Issue Date
2011
Citation
American Journal of Cardiology, Vol.107(12) : 1783-1786, 2011
ISSN
0002-9149
Abstract
Despite the widespread adoption of drug-eluting stent (DES) implantation, the optimal treatment of DES failures remains challenging. The present study evaluated the relation between quantitative angiography and the fractional flow reserve (FFR) in restenotic lesions after DES implantation and the efficacy of FFR in determining whether to treat these lesions. To assess their functional significance, the coronary pressure-derived FFR was measured in 50 DES restenotic lesions (49 patients). Additional intervention was performed in lesions with a FFR <0.8. Major adverse cardiac events were assessed at 12 months after the reintervention procedure. The mean percent diameter stenosis (%DS) was 58 13%. Of the 50 lesions, 20 (40%) were deferred without additional intervention. The FFR and %DS had a negative correlation (r 0.61, p <0.001). However, when only the lesions with diffuse-type restenosis (15 lesions) were analyzed, the degree of correlation decreased (r 0.56, p 0.12). Although most lesions (89%) with a %DS of >70 had significant functional ischemia, among 41 lesions with a %DS <70, only 20 (49%) had demonstrated functional patency. The incidence of adverse events during the 12 months of follow-up after FFR-guided treatment was 18.0% (23.3% in the FFR <0.80 group and 10.0% in FFR >0.80 group). In conclusion, a discrepancy was found between functional ischemia measured by the FFR and the angiographic %DS, in particular, in moderate- or diffuse-type restenotic lesions after DES implantation. The outcome of FFR-guided deferral in patients with DES in-stent restenosis seems favorable. © 2011 Elsevier Inc. All rights reserved. (Am J Cardiol 2011;107:1783–1786)
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/34900
Appears in Collections:
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학)
Keimyung Author(s)
남창욱; 조윤경; 허승호; 김권배; 정인성
Full Text
https://linkinghub.elsevier.com/retrieve/pii/S0002914911010162
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