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

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Author(s)
남창욱조윤경허승호김권배정인성
Alternative Author(s)
Nam, Chang WookCho, Yun KyeongHur, Seung HoKim, Kwon BaeChung, In Sung
Publication Year
2011
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)
Department
Dept. of Internal Medicine (내과학)
Dept. of Preventive Medicine (예방의학)
Publisher
School of Medicine
Citation
American Journal of Cardiology, Vol.107(12) : 1783-1786, 2011
Type
Article
ISSN
0002-9149
DOI
10.1016/j.amjcard.2011.02.328
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/34900
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