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Physiological evaluation of the provisional side-branch intervention strategy for bifurcation lesions using fractional flow reserve.

Authors
Koo, BK; Park, KW; Kang, HJ; Cho, YS; Chung, WY; Youn, TJ; Chae, IH; Choi, DJ; Tahk, SJ; Oh, BH; Park, YB; Kim, HS
Citation
European heart journal, 29(6):726-732, 2008
Journal Title
European heart journal
ISSN
0195-668X1522-9645
Abstract
AIMS: This study was performed to evaluate the functional outcomes of fractional flow reserve (FFR)-guided jailed side-branch (SB) intervention strategy. METHODS AND RESULTS: One hundred and ten patients treated by provisional strategy were consecutively enrolled and SB FFR was measured in 91 patients. SB intervention was allowed when FFR was <0.75. FFR measurement was repeated after SB intervention and at 6-month follow-up angiography. In 26 of 28 SB lesions with FFR <0.75, balloon angioplasty (SB balloon/artery ratio = 0.84 +/- 0.14) was performed and FFR >or=0.75 was achieved in 92% of the lesions although the mean residual stenosis was 69 +/- 10%. During follow-up, there were no changes in SB FFR in lesions with (0.86 +/- 0.05 to 0.84 +/- 0.01, P = 0.4) and without SB angioplasty (0.87 +/- 0.06 to 0.89 +/- 0.07, P = 0.1). Functional restenosis (FFR <0.75) rate was only 8% (5/65). When clinical outcomes of these patients were compared with 110 patients with similar bifurcation lesions treated without FFR-guidance, there was no difference in 9-month cardiac event rates (4.6 vs. 3.7%, P = 0.7) between the two groups. CONCLUSION: In conclusion, FFR-guided SB intervention strategy resulted in good functional outcomes.
MeSH terms
Balloon DilationCoronary Stenosis/drug therapyCoronary Stenosis/physiopathology*Death, Sudden, Cardiac/etiologyDrug-Eluting StentsFemaleFollow-Up StudiesFractional Flow Reserve, Myocardial/physiology*HumansMaleMiddle AgedMyocardial Infarction/etiologyMyocardial Revascularization/statistics & numerical dataTreatment Outcome
DOI
10.1093/eurheartj/ehn045
PMID
18308689
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Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
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