Changes in coronary collateral function after successful chronic total occlusion percutaneous coronary intervention

被引：3

作者：

Keulards, Danielle C. J. ^{[1
]}

Alsanjari, Osama ^{[2
,3
,4
]}

Keeble, Thomas R. ^{[2
,3
]}

Vlaar, Pieter-Jan ^{[1
]}

Kelly, Paul A. ^{[2
]}

Tang, Kare H. ^{[2
]}

Khan, Sarosh ^{[2
,3
]}

Cockburn, James ^{[4
]}

Pijls, Nico H. J. ^{[1
]}

Hildick-Smith, David ^{[4
]}

Teeuwen, Koen ^{[1
]}

Davies, John ^{[2
,3
]}

V. Karamasis, Grigoris ^{[2
,3
,5
]}

机构：

[1] Catharina Hosp, Cardiol Dept, Eindhoven, Netherlands

[2] Mid & South Essex NHS Fdn Trust, Essex Cardiothorac Ctr, Cardiol Dept, Basildon, England

[3] Anglia Ruskin Univ, Sch Med, Chelmsford, England

[4] Brighton & Sussex Univ Hosp, Sussex Cardiac Ctr, Cardiol Dept, Brighton, England

[5] Basildon Univ Hosp, Mid & South Essex NHS Fdn Trust, Essex Cardiothorac Ctr, Basildon SS16 5NL, Essex, England

来源：

EUROINTERVENTION | 2022年 / 18卷 / 11期

关键词：

chronic coronary total occlusion; fractional flow reserve; other technique; stable angina; RECANALIZATION; PRESSURE; FLOW; ARTERY; VELOCITY; STEAL;

D O I：

10.4244/EIJ-D-22-00118

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Contemporary chronic total occlusion (CTO) percutaneous coronary intervention (PCI) incorporates wire escalation and dissection/re-entry recanalisation strategies.Aims: The purpose of the study was to investigate changes in collateral function after CTO PCI and to identify whether the mode of successful recanalisation influences collateral function regression. Methods: Patients scheduled for elective CTO PCI with evidence of viability in the CTO territory by non-invasive imaging were included in this study. After successful CTO PCI, the aortic pressure (Pa) and distal coronary artery wedge pressure (Pw) during balloon occlusion were measured, both in a resting state and during infusion of intravenous adenosine, allowing the calculation of the pressure-derived collateral pres-sure index at rest and hyperaemia (CPIrest and the collateral fractional flow reserve [FFRcoll], respectively). Measurements were repeated 3 months later during angiographic follow-up.Results: Eighty-one patients had physiological measurements at baseline and follow-up. In the final cohort the mean age was 64 years and 82% were male. The mean maximal stent diameter and total stent length were 3.2 +/- 0.5 mm and 68 +/- 31 mm, respectively. Successful strategies were antegrade wiring (64.2%), antegrade dissection re-entry (8.6%), and retrograde dissection re-entry (27.1%). Between the index pro-cedure and follow-up, wedge pressure decreased from 34 +/- 11 mmHg to 21 +/- 8.5 mmHg (p<0.01), respec-tively. FFRcoll changed from 0.34 +/- 0.11 to 0.19 +/- 0.09 (p<0.01) at follow-up and CPIrest from 0.40 +/- 0.14 to 0.17 +/- 0.09 (p<0.01). Absolute maximum collateral flow decreased from 55 +/- 32 ml/min directly after PCI to 38 +/- 24 ml/min (p<0.01). There was no relation between the recanalisation technique and changes in FFRcoll. Conclusions: There was a significant reduction in collateral flow over time, independent of the recanal-isation technique.

引用

页码：920 / +

页数：10

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