scholarly journals TCTAP C-216 Effect of Breath Holding on Coronary Stenosis Sandwiched Between Aorta and Pulmonary Artery Assessed with Intravascular Ultrasound and Fractional Flow Reserve

2019 ◽  
Vol 73 (15) ◽  
pp. S276
Author(s):  
Yusuke Nakano ◽  
Tajima Atomu ◽  
Katsuhisa Waseda ◽  
Mayu Suzuki ◽  
Hirofumi Ohashi ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Intravascular Ultrasound ◽  
Fractional Flow Reserve ◽  
Coronary Stenosis ◽  
Breath Holding ◽  
Fractional Flow ◽  
Flow Reserve

scholarly journals Lesion Length Improves Diagnostic Accuracy of Intravascular Ultrasound for Detecting Functional Intermediate Coronary Stenosis Evaluated With Coronary Angiography-Derived Fractional Flow Reserve in Non-left Main Artery

2021 ◽  
Vol 8 ◽  
Author(s):  
Menghuan Li ◽  
Iokfai Cheang ◽  
Yuan He ◽  
Shengen Liao ◽  
Hui Wang ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Diagnostic Accuracy ◽  
Intravascular Ultrasound ◽  
Fractional Flow Reserve ◽  
Coronary Stenosis ◽  
Lesion Length ◽  
Left Main ◽  
Fractional Flow ◽  
Main Artery ◽  
Flow Reserve

Objective: Intravascular ultrasound (IVUS) parameters, for example, minimal lumen area (MLA) and area stenosis (AS), poorly identified functional intermediate coronary stenosis (ICS). For detecting functional ICS defined by coronary angiography-derived fractional flow reserve (caFFR), our study aims to determine whether IVUS parameters integrated with lesion length (LL) by three-dimensional quantitative coronary analysis (3D-QCA) could improve diagnostic value.Methods: A total of 111 patients with 122 ICS lesions in the non-left main artery were enrolled. MLA and AS were calculated in all lesions by IVUS. Diameter stenosis (DS%) and LL were measured by 3D-QCA. caFFR was computed by the proprietary fluid dynamic algorithm, a caFFR ≤ 0.8 was considered as functional stenosis. Receiver-operating curve analyses were used to compare the diagnostic accuracy among indices to predict functional stenoses.Results: Mean caFFR values in all lesions were 0.86 ± 0.09. Lesions with caFFR ≤ 0.8 showed lower MLA and higher AS (MLA: 3.3 ± 0.8 vs. 4.1 ± 1.2, P = 0.002; AS: 71.3 ± 9.6% vs. 63.5 ± 1.3%, P = 0.007). DS% and LL were more severe in lesions with caFFR ≤ 0.8 (DS%: 45.5 ± 9.6% vs. 35.5 ± 8.2%, P < 0.001; LL: 31.6 ± 12.9 vs. 21.0 ± 12.8, P < 0.001). caFFR were correlated with MLA, AS, and LL (MLA: r = 0.36, P < 0.001; AS: r = −0.36, P < 0.001; LL: r = −0.41, P < 0.001). Moreover, a multiple linear regression analysis demonstrated that MLA (β = 0.218, P = 0.013), AS (β = −0.197, P = 0.029), and LL (β = −0.306, P > 0.001) contributed significantly to the variation in caFFR. The best cutoff value of MLA, AS, and LL for predicting caFFR ≤ 0.8 were 3.6 mm2, 73%, and 26 mm, with area under the curve (AUC) of 0.714, 0.688, and 0.767, respectively. Combined with MLA, AS, and LL for identifying functional ICS, the accuracy was the highest among study methods (AUC: 0.845, P < 0.001), and was significantly higher than each single method (All P < 0.05).Conclusion: Lesion length can improve the diagnostic accuracy of IVUS-derived parameters for detecting functional ICS.

NEW CUT-OFF VALUE OF IVUS MINIMAL LUMEN AREA (MLA) AND FRACTIONAL FLOW RESERVE (FFR) TO DEFINE THE FUNCTIONAL SIGNIFICANCE OF DENOVO INTERMEDIATE CORONARY STENOSIS

2015 ◽  
pp. 11-19
Author(s):  
Minh Hung Ngo ◽  
Anh Tien Hoang ◽  
Cuu Long Nguyen ◽  
Thanh Nhan Vo ◽  
Phan Tuong Quynh Le ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Fractional Flow Reserve ◽  
Functional Significance ◽  
Coronary Stenosis ◽  
Lumen Area ◽  
Plaque Volume ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Minimal Lumen Area ◽  
Study Results

Background: Intravascular Ultrasound (IVUS) is a supportive tool for coronary angiography in evaluating intermediate coronary lesions. However, old cut-off value of 4mm2 of IVUS Minimal Lumen Area (MLA) has been proved very low diagnosic accuracy. Objective: We aimed to assess a new cut-off value of IVUS MLA and its diagnostic performance to predict ischemia, using fractional flow reserve (FFR) as gold standard. Methods: Denovo Intermediate lesions were evaluated with both IVUS and FFR. A total of 32 lesions were enrolled into the study. Results: Thirty two patients, who had denovo intermediate lesions distributing at prox-mid segment of RCA (31.3%), LAD (59.4%) and LCx (6.2%), were enrolled into this study, with average age: 63.97±11.59 (years), male: 71.9% and female: 28.1%, mean diameter stenosis: 50.68% ± 8.83 and mean reference diameter: 2.99 mm ± 0.61mm. IVUS MLA (r = 0.386, p < 0.014) correlated with FFR. The stenotic diameter (r = -0.159, p < 0.192), the length (r = -0.052, p = 0.389) and the plaque volume (r = -0.105, p = 0.284) didn’t well correlate with FFR. Best cut-off value (BCV) of IVUS MLA to define the functional significance (FFR ≤0.8) was 2.55 mm2 (AUC 0.776; 95% CI 0.607-0.946) with sensitivity and specitivity were 66.7% and 88.2% respectively. Conclusion: In this study, an IVUS MLA of 2.55 mm2 was the BCV to define the functional significance of denovo intermediate coronary stenosis. However, when IVUS MLA is used to determine the functional significance, both the lesion diameter and length should be considered. Key words: intermediate lesion, intravascular ultrasound (IVUS), Fractional Flow Reserve (FFR)

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