Background: In superficial femoral artery (SFA) stenosis, stenosis resistance may increase, but the relationship between stenosis resistance and stenotic severity remains to be seen. This study aimed to investigate the physiological response, through a hyperemic condition, and the pathophysiological significance of Doppler flow and stenosis resistance in SFA. Methods: Twenty-four limbs with focal stenosis of the SFA were analyzed. We assessed the fractional flow reserve (FFR), hyperemic stenosis resistance (h-SR), and vascular flow reserve (VFR) of the SFA with a pressure/Doppler flow sensor-tipped combination guidewire before and after endovascular therapy (EVT). Results: FFR, h-SR, and VFR changed significantly after EVT. h-SR was more strongly correlated with % area stenosis, measured by intravascular ultrasound than FFR (FFR: r=-0.716, h-SR: r=0.741, p<0.0001, respectively). However, VFR was not associated with % area stenosis. A receiver operating characteristic curve showed cut-offs h-SR >0.36 mmHg·sec/cm, and FFR <0.88 predicted >75% area stenosis with area under curves of 0.883 and 0.828, respectively. Conclusion: h-SR can indicate stenotic severity in an SFA focal lesion more prominently than FFR and may be a new physiological index to determine indication for EVT. VFR was not feasible for assessment in SFA focal stenosis.
Background: In superficial femoral artery (SFA) stenosis, stenosis resistance may increase, but the relationship between stenosis resistance and stenotic severity remains to be seen. This study aimed to investigate the physiological response, through a hyperemic condition, and the pathophysiological significance of Doppler flow and stenosis resistance in SFA. Methods: Twenty-four limbs with focal stenosis of the SFA were analyzed. We assessed the fractional flow reserve (FFR), hyperemic stenosis resistance (h-SR), and vascular flow reserve (VFR) of the SFA with a pressure/Doppler flow sensor-tipped combination guidewire before and after endovascular therapy (EVT). Results:FFR, h-SR, and VFR changed significantly after EVT. h-SR was more strongly correlated with % area stenosis, measured by intravascular ultrasound than FFR (FFR: r=-0.716, h-SR: r=0.741, p<0.0001, respectively). However, VFR was not associated with % area stenosis. A receiver operating characteristic curve showed cut-offs h-SR >0.36 mmHg·sec/cm, and FFR <0.88 predicted >75% area stenosis with area under curves of 0.883 and 0.828, respectively. Conclusion: h-SR can indicate stenotic severity in an SFA focal lesion more prominently than FFR and may be a new physiological index to determine indication for EVT. VFR was not feasible for assessment in SFA focal stenosis.
Authors: C Briguori; A Anzuini; F Airoldi; G Gimelli; T Nishida; M Adamian; N Corvaja; C Di Mario; A Colombo Journal: Am J Cardiol Date: 2001-01-15 Impact factor: 2.778
Authors: M Meuwissen; S A Chamuleau; M Siebes; C E Schotborgh; K T Koch; R J de Winter; M Bax; A de Jong; J A Spaan; J J Piek Journal: Circulation Date: 2001-01-16 Impact factor: 29.690
Authors: Maria Siebes; Bart-Jan Verhoeff; Martijn Meuwissen; Robbert J de Winter; Jos A E Spaan; Jan J Piek Journal: Circulation Date: 2004-02-17 Impact factor: 29.690
Authors: Martijn Meuwissen; Maria Siebes; Steven A J Chamuleau; Berthe L F van Eck-Smit; Karel T Koch; Robbert J de Winter; Jan G P Tijssen; Jos A E Spaan; Jan J Piek Journal: Circulation Date: 2002-07-23 Impact factor: 29.690
Authors: N H Pijls; B De Bruyne; K Peels; P H Van Der Voort; H J Bonnier; J J Bartunek J Koolen; J J Koolen Journal: N Engl J Med Date: 1996-06-27 Impact factor: 91.245