FFR result post PCI is suboptimal in long diffuse coronary artery disease

被引:35
作者
Baranauskas, Arvydas [1 ,2 ]
Peace, Aaron [3 ,4 ]
Kibarskis, Aleksandras [1 ,2 ]
Shannon, Joanne [4 ]
Abraitis, Vytautas [1 ,2 ]
Bajoras, Vilhelmas [1 ]
Bilkis, Valdas [1 ,2 ]
Aidietis, Audrius [1 ,2 ]
Laucevicius, Aleksandras [1 ,2 ]
Davidavicius, Giedrius [1 ,2 ]
机构
[1] Vilnius Univ, Fac Med, Vilnius, Lithuania
[2] Vilnius Univ Hosp Santariskiu Klin, Ctr Cardiol & Angiol, Vilnius, Lithuania
[3] WHSCT, Altnagelvin Hosp, Dept Cardiol, Derry, Londonderry, North Ireland
[4] Frimley Pk Hosp, Frimley, Surrey, England
关键词
diffuse disease; drug-eluting stent; fractional flow reserve; FRACTIONAL FLOW RESERVE; DRUG-ELUTING STENTS; CLINICAL-OUTCOMES; FOLLOW-UP; RANDOMIZED-TRIAL; ANGIOGRAPHY; INTERVENTION; IMPLANTATION; EVEROLIMUS; REGISTRY;
D O I
10.4244/EIJ-D-15-00514
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims: The aim of this study was to evaluate the functional result immediately post PCI and at nine-month follow-up, and to ascertain how often a functionally optimal result of >0.95 can be achieved in long coronary lesions treated with long second-or newer-generation DES. Methods and results: Patients receiving DES measuring >= 30 mm with FFR value <= 0.8 were included in the study. Stent length was defined as long (30 to 49 mm; L-DES) and ultra-long (>= 50 mm; UL-DES). Angiographic and FFR evaluation was performed before and after PCI and at nine-month follow-up. A total of 74 patients each received a mean stent length of 50.72 +/- 14.6 mm. Mean FFR post PCI was 0.88 +/- 0.06. An optimal post PCI FFR value of >0.95 was achieved in only 9/74 patients (12.2%), and was not achieved in any UL-DES patients. Only 12/74 (16.2%) had FFR post PCI of 0.91 to 0.95; 8/74 (10.8%) patients remained ischaemic (<= 0.8). FFR gradient across the stent was higher in UL-DES patients compared to L-DES patients (0.07 +/- 0.03 vs. 0.04 +/- 0.03; p=0.001). At follow-up, the angiographic restenosis rate was 4.7%, and the functional restenosis rate was 15.1%. Conclusions: The FFR result post PCI was suboptimal in the majority of patients treated with long DES and was particularly poor when the total stent length exceeded 50 mm.
引用
收藏
页码:1473 / 1480
页数:8
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