scholarly journals Case Report: Combination of Pressure Guidewire and Optical Coherence Tomography-Guided Drug-Coated Balloon Revascularization for Renal Artery Fibromuscular Dysplasia

2022 ◽  
Vol 8 ◽  
Author(s):  
Yuxi Li ◽  
Xinyan Wen ◽  
Bo Zheng ◽  
Ming Chen ◽  
Wei Ma ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Renovascular Hypertension ◽  
Fibromuscular Dysplasia ◽  
Optical Coherence ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Drug Coated Balloon ◽  
Selection Of

Fibromuscular dysplasia (FMD) is the second common cause of renovascular hypertension. With the advent of endovascular therapy, angiography has become a diagnostic gold standard for FMD. Optical coherence tomography (OCT) by reflecting in vivo histology may improve diagnostic and classification accuracy. Renal fractional flow reserve (rFFR), measured by pressure guidewire, may distinguish the patients who may benefit from revascularization by identifying physiologically significant stenoses. However, the role of usage of both OCT and rFFR is not well-studied. We herein report a 17-year-old male with renovascular hypertension due to FMD. Angioplasty of drug-coated balloon (DCB) guided by OCT and FFR favorably achieved blood pressure (BP) control. In conclusion, the utility of both OCT and FFR may be useful for the appropriate selection of patients with renal FMD.

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.

Sign in / Sign up

Export Citation Format

Share Document