医学
部分流量储备
狭窄
核医学
协议限制
心脏病学
心导管插入术
内科学
外科
冠状动脉造影
心肌梗塞
作者
Christophe Pouillot,Stéphane Fournier,Jens Glasenapp,G. Rambaud,K. Bougrini,R. Vi Fane,Christophe Geyer,Julien Adjedj
出处
期刊:Eurointervention
[Europa Digital and Publishing]
日期:2018-02-01
卷期号:13 (15): e1850-e1856
被引量:17
标识
DOI:10.4244/eij-d-17-00238
摘要
Recently developed microcatheters can be used instead of a pressure wire for fractional flow reserve (FFR) measurement. We sought to assess the haemodynamic and clinical impact of using a larger profile device to measure FFR.Our prospective registry included 77 consecutive patients who underwent invasive FFR measurement of intermediate coronary stenoses between June 2015 and July 2016. FFR values were obtained first using a pressure wire only (FFRw), second using a Navvus microcatheter (FFRMC), and finally using the wire with the microcatheter still in the stenosis (FFRw-MC) during intravenous adenosine infusion. Eighty-eight stenoses were suitable for a thorough head-to-head comparison. Mean FFRw (0.83±0.08) was significantly higher than mean FFRMC (0.80±0.10) and FFRw-MC (0.80±0.10). Mean FFRMC and FFRw-MC did not differ significantly. Bland-Altman analysis showed a bias of -0.03±0.05 for lower FFRMC values compared to FFRw values. Using a threshold of 0.80 for FFR, the indication for revascularisation would have differed when based on FFRMC versus FFRw in 20/88 (23%) of the lesions and 18/77 (23%) of the patients.FFR measured using a microcatheter overestimates stenosis severity, leading to erroneous indication for revascularisation in a sizeable proportion of cases.
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