AIMS: The aim of this study was to evaluate the functional result immediately post PCI and at nine-month follow-up, and to ascertain how often a functionally optimal result of >0.95 can be achieved in long coronary lesions treated with long second- or newer-generation DES. METHODS AND RESULTS: Patients receiving DES measuring ≥30 mm with FFR value ≤0.8 were included in the study. Stent length was defined as long (30 to 49 mm; L-DES) and ultra-long (≥50 mm; UL-DES). Angiographic and FFR evaluation was performed before and after PCI and at nine-month follow-up. A total of 74 patients each received a mean stent length of 50.72±14.6 mm. Mean FFR post PCI was 0.88±0.06. An optimal post PCI FFR value of >0.95 was achieved in only 9/74 patients (12.2%), and was not achieved in any UL-DES patients. Only 12/74 (16.2%) had FFR post PCI of 0.91 to 0.95; 8/74 (10.8%) patients remained ischaemic (≤0.8). FFR gradient across the stent was higher in UL-DES patients compared to L-DES patients (0.07±0.03 vs. 0.04±0.03; p=0.001). At follow-up, the angiographic restenosis rate was 4.7%, and the functional restenosis rate was 15.1%. CONCLUSIONS: The FFR result post PCI was suboptimal in the majority of patients treated with long DES and was particularly poor when the total stent length exceeded 50 mm.
AIMS: The aim of this study was to evaluate the functional result immediately post PCI and at nine-month follow-up, and to ascertain how often a functionally optimal result of >0.95 can be achieved in long coronary lesions treated with long second- or newer-generation DES. METHODS AND RESULTS:Patients receiving DES measuring ≥30 mm with FFR value ≤0.8 were included in the study. Stent length was defined as long (30 to 49 mm; L-DES) and ultra-long (≥50 mm; UL-DES). Angiographic and FFR evaluation was performed before and after PCI and at nine-month follow-up. A total of 74 patients each received a mean stent length of 50.72±14.6 mm. Mean FFR post PCI was 0.88±0.06. An optimal post PCI FFR value of >0.95 was achieved in only 9/74 patients (12.2%), and was not achieved in any UL-DES patients. Only 12/74 (16.2%) had FFR post PCI of 0.91 to 0.95; 8/74 (10.8%) patients remained ischaemic (≤0.8). FFR gradient across the stent was higher in UL-DES patients compared to L-DESpatients (0.07±0.03 vs. 0.04±0.03; p=0.001). At follow-up, the angiographic restenosis rate was 4.7%, and the functional restenosis rate was 15.1%. CONCLUSIONS: The FFR result post PCI was suboptimal in the majority of patients treated with long DES and was particularly poor when the total stent length exceeded 50 mm.
Authors: Roberto Diletti; Kaneshka Masdjedi; Joost Daemen; Laurens J C van Zandvoort; Tara Neleman; Jeroen Wilschut; Wijnand K Den Dekker; Rutger J van Bommel; Miguel Lemmert; Isabella Kardys; Paul Cummins; Peter de Jaegere; Felix Zijlstra; Nicolas M Van Mieghem Journal: Circ Cardiovasc Interv Date: 2021-03-09 Impact factor: 6.546
Authors: Damien Collison; Matthaios Didagelos; Muhammad Aetesam-Ur-Rahman; Samuel Copt; Robert McDade; Peter McCartney; Thomas J Ford; John McClure; Mitchell Lindsay; Aadil Shaukat; Paul Rocchiccioli; Richard Brogan; Stuart Watkins; Margaret McEntegart; Richard Good; Keith Robertson; Patrick O'Boyle; Andrew Davie; Adnan Khan; Stuart Hood; Hany Eteiba; Colin Berry; Keith G Oldroyd Journal: Eur Heart J Date: 2021-12-01 Impact factor: 29.983