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Clinical and Physiological Outcomes of Fractional Flow Reserve-Guided Percutaneous Coronary Intervention in Patients With Serial Stenoses Within One Coronary Artery

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Author(s)
Hack-Lyoung KimBon-Kwon KooChang-Wook NamJoon-Hyung DohJi-Hyun KimHan-Mo YangKyung-Woo ParkHae-Young LeeHyun-Jae KangYoung-Seok ChoTae-Jin YounSang-Hyun KimIn-Ho ChaeDong-Ju ChoiHyo-Soo KimByung-Hee OhYoung-Bae Park
Keimyung Author(s)
Nam, Chang Wook
Department
Dept. of Internal Medicine (내과학)
Journal Title
JACC: Cardiovascular Interventions
Issued Date
2012
Volume
5
Issue
10
Keyword
coronary diseasefractional flow reservephysiologystenosis
Abstract
Objectives:

This study was performed to evaluate the physiological and clinical outcomes of fractional flow reserve (FFR)-guided revascularization strategy with drug-eluting stents in serial stenoses within the same coronary artery.


Background:

Identifying a functionally significant stenosis is difficult when several stenoses exist within 1 coronary artery.


Methods:

A total of 131 patients (141 vessels and 298 lesions) with multiple intermediate stenoses within the same coronary artery were assessed by FFR with pullback pressure tracings. In vessels with an FFR <0.8, the stenosis that caused the largest pressure step-up was stented first. Major adverse cardiac events were assessed during follow-up.


Results:

FFR was measured 239 times and there were no procedure-related complications. There was a weak negative correlation between FFR and angiographic percent diameter stenosis (r = −0.282, p < 0.001). In total, 116 stents were implanted and revascularization was deferred in 61.1% (182 of 298) of lesions. When the vessels with an initial FFR <0.8 were divided into 2 groups according to FFR after first stenting (FFR ≥0.8 vs. FFR <0.8), there were no differences in baseline angiographic and physiological parameters between the 2 groups. During the mean follow-up of 501 ± 311 days, there was only 1 target vessel revascularization due to in-stent restenosis. There were no events related to deferred lesions.


Conclusions:

FFR-guided revascularization strategy using pullback pressure tracing in serial stenoses was safe and effective. This strategy can reduce unnecessary intervention and maximize the benefit of percutaneous coronary intervention with drug-eluting stents in patients with multiple stenoses within 1 coronary artery.
Keimyung Author(s)(Kor)
남창욱
Publisher
School of Medicine
Citation
Hack-Lyoung Kim et al. (2012). Clinical and Physiological Outcomes of Fractional Flow Reserve-Guided Percutaneous Coronary Intervention in Patients With Serial Stenoses Within One Coronary Artery. JACC: Cardiovascular Interventions, 5(10), 1013–1018. doi: 10.1016/j.jcin.2012.06.017
Type
Article
ISSN
1936-8798
DOI
10.1016/j.jcin.2012.06.017
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33902
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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