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

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.