Functional assessment of tandem coronary artery stenosis by intracoronary optical coherence tomography-derived virtual fractional flow reserve: a case series
Open Access
- 24 May 2019
- journal article
- research article
- Published by Oxford University Press (OUP) in European Heart Journal - Case Reports
- Vol. 3 (2)
- https://doi.org/10.1093/ehjcr/ytz087
Abstract
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. 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. 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.Keywords
This publication has 11 references indexed in Scilit:
- Pre-Angioplasty Instantaneous Wave-Free Ratio Pullback Predicts Hemodynamic Outcome In Humans With Coronary Artery Disease Primary Results of the International Multicenter iFR GRADIENT RegistryКАРДИОЛОГИЯ УЗБЕКИСТАНА, 2018
- Intracoronary Optical Coherence Tomography-Derived Virtual Fractional Flow Reserve for the Assessment of Coronary Artery DiseaseThe American Journal of Cardiology, 2017
- Serial Optical Coherence Tomography and Intravascular Ultrasound Analysis of Gender Difference in Changes of Plaque Phenotype in Response to Lipid-Lowering TherapyThe American Journal of Cardiology, 2016
- Optical coherence tomography imaging during percutaneous coronary intervention impacts physician decision-making: ILUMIEN I studyEuropean Heart Journal, 2015
- Change in Coronary Blood Flow After Percutaneous Coronary Intervention in Relation to Baseline Lesion PhysiologyCirculation: Cardiovascular Interventions, 2015
- Fractional Flow Reserve to Guide Coronary RevascularizationCirculation Journal, 2013
- Usefulness of Minimal Luminal Coronary Area Determined by Intravascular Ultrasound to Predict Functional Significance in Stable and Unstable Angina PectorisThe American Journal of Cardiology, 2012
- Economic Evaluation of Fractional Flow Reserve–Guided Percutaneous Coronary Intervention in Patients With Multivessel DiseaseCirculation, 2010
- Fractional Flow Reserve Versus Angiography for Guiding Percutaneous Coronary Intervention in Patients With Multivessel Coronary Artery Disease: 2-Year Follow-Up of the FAME (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) StudyJournal of the American College of Cardiology, 2010
- Fractional Flow ReserveCirculation, 1995