scholarly journals Predicting Fractional Flow Reserve Using Optical Coherence Tomography Parameters In Patients With Stable Chest Pain Versus Acute Coronary Syndromes

2012 ◽  
Vol 21 ◽  
pp. S169
Author(s):  
R. Poulter ◽  
I. Lim ◽  
S. Hoole ◽  
D. Wood ◽  
J. Saw ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Chest Pain ◽  
Fractional Flow Reserve ◽  
Acute Coronary Syndromes ◽  
Optical Coherence ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Coronary Syndromes ◽  
Stable Chest Pain

P6175Prediction of coronary revascularization by coronary computed tomography angiography derived fractional flow reserve - different algorithms for interpretation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K T Madsen ◽  
K T Veien ◽  
B L Noergaard ◽  
P Larsen ◽  
L Deibjerg ◽  
...  
Keyword(s):  
Chest Pain ◽  
Fractional Flow Reserve ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Coronary Revascularization ◽  
Standard Of Care ◽  
Fractional Flow ◽  
Coronary Cta ◽  
Flow Reserve ◽  
Stable Chest Pain

Abstract Introduction Coronary CT angiography (CTA) derived fractional flow reserve (FFRct) is increasingly used for guiding referral to invasive procedures in patients with stable chest pain. However, optimal interpretation of FFRct-analysis in terms of location and threshold of applied FFRct-values is unclear. Purpose To evaluate the clinical performance of various vessel-specific physiological FFRct derived measures of ischemia for prediction of standard of care guided coronary revascularization in patients with stable chest pain and coronary artery disease as determined by coronary CTA. Methods Retrospective study in patients with stable chest pain referred for coronary angiography based on coronary CTA. Standard acquired coronary CTA data sets were transmitted for core-laboratory analysis at HeartFlow. Any FFRct value in the major coronary arteries ≥1.8 mm in diameter, including side branches, were registered. Lesions were categorized as positive for ischemia using 6 different algorithms: Lowest in vessel FFRct-value (1) ≤0.75 or (2) ≤0.80; 2 cm distal-to-lesion FFRct-value (3) ≤0.75 or (4) ≤0.80; ΔFFRct (5) ≥0.06 or a combination of 2 and 5. The personnel responsible for downstream patient management had no information regarding FFRct test results. Results A total of 172 patients were included. Revascularization was performed in 62 (35%) patients. The diagnostic performance of different FFRct algorithms for predicting standard of care guided coronary revascularization is shown in the Table. Revascularization Predictions by FFRct N=172 Diagnostic performance FFRCT false negative FFRCT false positive Values given as (%) No. of revasc vessels No. of abnormal vessels FFRCT Algorithm Sens Spec PPV NPV Acc 1 2 3 1 2 3 Distal FFRCT ≤0.75 77 68 58 84 72 12 2 0 29 5 1 Distal FFRCT ≤0.80 92 43 48 90 61 5 0 0 40 20 3 Lesion-specific FFRCT ≤0.75 68 86 74 83 80 17 3 0 12 3 0 Lesion-specific FFRCT ≤0.80 82 78 68 89 80 10 2 0 21 3 1 ΔFFRCT ≥0.06 98 36 47 98 59 1 0 0 51 19 0 Combinationa 92 54 53 92 67 5 0 0 39 12 0 aDistal FFRCT ≤0.80 and ΔFFRCT ≥0.06. Sens = sensitivity; Spec = specificity; PPV = positive predictive value; NPV = negative predictive value; Acc = accuracy; FFRCT = fractional flow reserve derived from coronary CTA; ΔFFRCT = difference between FFRCT-value immediately proximal and distal to lesion; Revasc = revascularized. Conclusion The diagnostic performance of FFRct in terms of predicting standard of care guided coronary revascularization is dependent on the applied algorithm for interpretation of the FFRct-analysis.

Clinical and prognostic value of poststenting fractional flow reserve in acute coronary syndromes

Heart ◽  
2016 ◽  
Vol 102 (24) ◽  
pp. 1988-1994 ◽  
Author(s):  
Srikanth Kasula ◽  
Shiv Kumar Agarwal ◽  
Yalcin Hacioglu ◽  
Nagavenkata Krishnachand Pothineni ◽  
Sabha Bhatti ◽  
...  
Keyword(s):  
Fractional Flow Reserve ◽  
Acute Coronary Syndromes ◽  
Prognostic Value ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Coronary Syndromes

scholarly journals Functional assessment of tandem coronary artery stenosis by intracoronary optical coherence tomography-derived virtual fractional flow reserve: a case series

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Yoshiyuki Okuya ◽  
Fumiyasu Seike ◽  
Kohei Yoneda ◽  
Takefumi Takahashi ◽  
Koichi Kishi ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Fractional Flow Reserve ◽  
Optical Coherence ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Proximal Lesion ◽  
A Value ◽  
The Wire ◽  
Tandem Lesions ◽  
Distal Site

Abstract Background Optical coherence tomography (OCT)-derived fractional flow reserve (FFR)—which may be calculated using fluid dynamics—demonstrated an excellent correlation with the wire-based FFR. However, the applicability of the OCT-derived FFR in the assessment of tandem lesions is currently unclear. Case summary We present two cases of tandem lesions in the mid segment of the left anterior descending (LAD) artery which could have assessed accurately by OCT-derived FFR. The first patient underwent wire-based FFR at the far distal site of LAD, showed a value of 0.66. The OCT-derived FFR was calculated, yielding a value of 0.64. In the absence of stenosis at the proximal lesion, the OCT-derived FFR was calculated as 0.79, which was as same as the wire-based FFR obtained after stenting to the proximal lesion. Thus, additional stenting was performed at the distal lesion. The second patient underwent wire-based FFR at the far distal site of LAD, showed a value of 0.76 which was as same vale as OCT-derived FFR. Considering the absence of stenosis in the proximal lesion, the OCT-derived FFR was estimated as 0.88. After coronary stenting in the proximal lesion, the wire-based FFR yielded a value of 0.90. Therefore, additional intervention to the distal lesion was deferred. Discussion The described reports are the first two cases which performed physiological assessment using OCT in tandem lesions. The OCT-derived FFR might be able to estimate the wire-based FFR and the severity of each individual lesion in patients with tandem lesions.

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