TCTAP C-102 Combining Fractional Flow Reserve and Optical Coherence Tomography Guided Percutaneous Coronary Intervention in Two-vessel Intermediate Coronary Artery Lesions

Background: Importance of Physiological study by Fractional Flow Reserve (FFR) in the management of patient with coronary artery disease (CAD is well established. Objective: Angiographic-guided percutaneous coronary intervention (PCI) is a common practice in Bangladeshi interventional era. Data on Pre-PCI physiological study by Fractional Flow Reserve (FFR) in our patient is not available. Therefore, our primary aim was to perform pre-PCI FFR to assess the angiographically significant coronary stenosis and thus to avoid inappropriate stenting. Methods: Total 22 patients (Male 20, Female 2) were enrolled in this observational non-randomized prospective cohort. Patient who had angiographically significant lesion, planned for physiological study by pre-PCI FFR. Cut off value for FFR were clinically significant only if Pd/Pa ratio <0.75 and differed stenting if > 0.76-0.80 or above. Results: In the studied patient population, FFR done in total 27 vessels of 22 patients. Among the vessel wise FFR distribution were in LAD 67%(18), LCX 14.8%(4), RCA 14.8%(4) and Ramus Intermedius 3.7% (1). FFR was nonsignificant (<0.75) in 59% (13) patients and significant (>0.75) were in 41%(9) patients. Conclusion: In this single center, very preliminary observational prospective cohort of non-randomized study, we found, that FFR is an important aid to perform PCI in patient with angiographically significant coronary lesion, and to avoid inappropriate stenting of insignificant stenosis by physiological study. Thus, to reduce cost and untoward effects of inappropriate stenting. Bangladesh Heart Journal 2019; 34(1) : 37-43

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Use of fractional flow reserve (FFR) in the assessment of coronary artery disease leads to reduction of percutaneous coronary intervention (PCI) patients

Heart Lung and Circulation ◽

10.1016/j.hlc.2015.06.469 ◽

2015 ◽

Vol 24 ◽

pp. S312

Author(s):

M. De Raya ◽

J. Holden ◽

O. Wayman ◽

D. Taylor

Keyword(s):

Coronary Artery Disease ◽

Percutaneous Coronary Intervention ◽

Coronary Artery ◽

Fractional Flow Reserve ◽

Coronary Intervention ◽

Fractional Flow ◽

Flow Reserve ◽

Percutaneous Coronary ◽

Artery Disease

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Comparing treatment outcomes of fractional flow reserve-guided and angiography-guided percutaneous coronary intervention in patients with multi-vessel coronary artery diseases: a systematic review and meta-analysis

Clinical & Investigative Medicine ◽

10.25011/cim.v39i1.26327 ◽

2016 ◽

Vol 39 (1) ◽

pp. 25 ◽

Cited By ~ 3

Author(s):

Jiancheng Xiu ◽

Gangbin Chen ◽

Hua Zheng ◽

Yuegang Wang ◽

Haibin Chen ◽

...

Keyword(s):

Myocardial Infarction ◽

Percutaneous Coronary Intervention ◽

Coronary Artery ◽

Fractional Flow Reserve ◽

Coronary Intervention ◽

Fractional Flow ◽

Flow Reserve ◽

Percutaneous Coronary ◽

Secondary Outcomes ◽

Vessel Coronary Artery

Purpose: Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) is used to assess the need for angioplasty in vessels with intermediate blockages. The treatment outcomes of FFR-guided vs. conventional angiography-guided PCI were evaluated in patients with multi-vessel coronary artery disease (CAD). Methods: Prospective and retrospective studies comparing FFR-guided vs. angiography-guided PCI in patients with multi-vessel CAD were identified from medical databases by two independent reviewers using the terms “percutaneous coronary intervention, fractional flow reserve, angiography, coronary heart disease, major adverse cardiac events (MACE) and myocardial infarction”. The primary outcome was the number of stents placed, and the secondary outcomes were procedure time, mortality, myocardial infarction (MI) and MACE rates. Results: Seven studies (three retrospective and four prospective), which included 49,517 patients, were included in this review. A total of 4,755 patients underwent FFR, while 44,697 received angiography-guided PCI. The mean patient age ranged from 58 to 71.7 years. The average number of stents used in FFR patients ranged from 0.3-1.9, and in angiography-guided PCI patients ranged from 0.7-2.7. Analysis indicated there was a greater number of stents placed in the angiography-guided group compared with the FFR group (pooled difference in means: -0.64, 95% confidence interval [CI]: -0.81 to -0.47, P < 0.001). There were no differences in the secondary outcomes between the two groups. Conclusions: Both procedures produce similar clinical outcomes, but the fewer number of stents used with FFR may have clinical as was as cost implications.

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