BACKGROUND: Fractional flow reserve (FFR) is the current gold standard to determine hemodynamic severity of angiographically intermediate coronary lesions. Much less is known about the prognostic effects of FFR measured directly after percutaneous coronary intervention (PCI). The aims of this study were to evaluate post-PCI FFR values, identify predictors for a low post-PCI FFR, and to investigate whether a relationship between postprocedural FFR and outcome during 30-day follow-up exists. METHODS AND RESULTS: The FFR-SEARCH (Fractional Flow Reserve-Stent Evaluated at Rotterdam Cardiology Hospital) is a prospective registry in which FFR measurements were performed after PCI in 1000 consecutive patients. All FFR measurements were performed under maximum hyperemia with intravenous adenosine with the Navvus RXi system (ACIST Medical Systems, Eden Prairie, MN). The clinical end point was defined as a composite of death, target vessel revascularization, or nonfatal myocardial infarction at 30-day follow-up. Measurement of post-PCI FFR was successful in 959 patients (96%), and a total of 1165 lesions were assessed. There were no complications related to the microcatheter. A total of 322 ST-segment-elevation myocardial infarction patients with 371 measured lesions were excluded leaving 637 patients with 794 measured lesions for the final analysis. Overall post-PCI FFR was 0.90±0.07. In 396 lesions (50%), post-PCI FFR was >0.90. A total of 357 patients (56%) had ≥1 lesion(s) with a post-PCI FFR ≤0.90, and 73 patients (11%) had ≥1 lesion(s) with a post-PCI FFR ≤0.80 with post-PCI FFR ≤0.80 in 78 lesions (9.8%). Complex lesion characteristics, use of multiple stents and smaller reference vessel diameter was associated with post-PCI FFR ≤0.90. During follow-up, 11 patients (1.8%) reached the clinical end point. There was no significant relationship between post-PCI FFR and the clinical end point at 30-day follow-up ( P=0.636). CONCLUSIONS: Routine measurement of post-PCI FFR using a monorail microcatheter is safe and feasible. Several lesion and patient characteristics were associated with a low post-PCI FFR. Post-PCI FFR did not correlate with clinical events at 30 days.
BACKGROUND: Fractional flow reserve (FFR) is the current gold standard to determine hemodynamic severity of angiographically intermediate coronary lesions. Much less is known about the prognostic effects of FFR measured directly after percutaneous coronary intervention (PCI). The aims of this study were to evaluate post-PCI FFR values, identify predictors for a low post-PCI FFR, and to investigate whether a relationship between postprocedural FFR and outcome during 30-day follow-up exists. METHODS AND RESULTS: The FFR-SEARCH (Fractional Flow Reserve-Stent Evaluated at Rotterdam Cardiology Hospital) is a prospective registry in which FFR measurements were performed after PCI in 1000 consecutive patients. All FFR measurements were performed under maximum hyperemia with intravenous adenosine with the Navvus RXi system (ACIST Medical Systems, Eden Prairie, MN). The clinical end point was defined as a composite of death, target vessel revascularization, or nonfatal myocardial infarction at 30-day follow-up. Measurement of post-PCI FFR was successful in 959 patients (96%), and a total of 1165 lesions were assessed. There were no complications related to the microcatheter. A total of 322 ST-segment-elevation myocardial infarctionpatients with 371 measured lesions were excluded leaving 637 patients with 794 measured lesions for the final analysis. Overall post-PCI FFR was 0.90±0.07. In 396 lesions (50%), post-PCI FFR was >0.90. A total of 357 patients (56%) had ≥1 lesion(s) with a post-PCI FFR ≤0.90, and 73 patients (11%) had ≥1 lesion(s) with a post-PCI FFR ≤0.80 with post-PCI FFR ≤0.80 in 78 lesions (9.8%). Complex lesion characteristics, use of multiple stents and smaller reference vessel diameter was associated with post-PCI FFR ≤0.90. During follow-up, 11 patients (1.8%) reached the clinical end point. There was no significant relationship between post-PCI FFR and the clinical end point at 30-day follow-up ( P=0.636). CONCLUSIONS: Routine measurement of post-PCI FFR using a monorail microcatheter is safe and feasible. Several lesion and patient characteristics were associated with a low post-PCI FFR. Post-PCI FFR did not correlate with clinical events at 30 days.
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: Pepijn A van Diemen; Ruben W de Winter; Stefan P Schumacher; Michiel J Bom; Roel S Driessen; Henk Everaars; Ruurt A Jukema; Yvemarie B Somsen; Lenka Popelkova; Peter M van de Ven; Albert C van Rossum; Tim P van de Hoef; Stefan de Haan; Koen M Marques; Jorrit S Lemkes; Yolande Appelman; Alexander Nap; Niels J Verouden; Maksymilian P Opolski; Ibrahim Danad; Paul Knaapen Journal: J Interv Cardiol Date: 2021-08-31 Impact factor: 2.279
Authors: Mariusz Tomaniak; Tara Neleman; Anniek Ziedses des Plantes; Kaneshka Masdjedi; Laurens J C van Zandvoort; Janusz Kochman; Wijnand K den Dekker; Jeroen M Wilschut; Roberto Diletti; Isabella Kardys; Felix Zijlstra; Nicolas M Van Mieghem; Joost Daemen Journal: J Clin Med Date: 2022-03-03 Impact factor: 4.241
Authors: Doyeon Hwang; Bon-Kwon Koo; Jinlong Zhang; Jiesuck Park; Seokhun Yang; Minsang Kim; Jun Pil Yun; Joo Myung Lee; Chang-Wook Nam; Eun-Seok Shin; Joon-Hyung Doh; Shao-Liang Chen; Tsunekazu Kakuta; Gabor G Toth; Zsolt Piroth; Nils P Johnson; Nico H J Pijls; Abdul Hakeem; Barry F Uretsky; Yohei Hokama; Nobuhiro Tanaka; Hong-Seok Lim; Tsuyoshi Ito; Akiko Matsuo; Lorenzo Azzalini; Massoud A Leesar; Tara Neleman; Nicolas M van Mieghem; Roberto Diletti; Joost Daemen; Damien Collison; Carlos Collet; Bernard De Bruyne Journal: JAMA Netw Open Date: 2022-09-01
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