Comparison of myocardial fractional flow reserve and intravascular ultrasound for the assessment of slotted-tube stents.
Intravascular ultrasound (IVUS) and myocardial fractional flow reserve (FFR) have been reported to provide similar results for assessment of coil stent deployment. Their relative value in slotted-tube stents has not been investigated. Fourteen patients subjected to coronary angioplasty and IVUS-guided elective stenting with a slotted-tube stent underwent IVUS assessment and FFR measurement following stent implantation at inflation pressures of 12 and 18 atm. FFR values (mean +/- SD) preangioplasty, postangioplasty, and poststenting at 12 atm and 18 atm, were 0.58 +/- 0.07, 0.83 +/- 0.05, 0.94 +/- 0.02, and 0.94 +/- 0.02, respectively. After inflation at 12 atm, the area under the receiver operating characteristic (ROC) curve for the concordance of IVUS and FFR measurements was 0.89 (P = 0.02). Six patients had either an abnormal IVUS (n = 2) or FFR < 0.94 (n = 1) or both abnormal IVUS and FFR < 0.94 (n = 3) after the first inflation and had a second inflation at 18 atm. The area under the ROC curve for the concordance between IVUS and FFR final measurements was 0.855 (P = 0.10). Perfect concordance between IVUS and FFR was seen only for FFR values less than 0.91 or larger than 0.94. Overall, IVUS and FFR have substantial concordance with respect to slotted-tube stent deployment. However, FFR values between 0.91 and 0.94 after inflation are difficult to interpret.
Department of Cardiology, Athens Euroclinic, Athens, Greece. dkatrits@otenet.gr
D G
DG
Katritsis
J P
JP
Ioannidis
S
S
Korovesis
E
E
Giazitzoglou
J
J
Parissis
P
P
Kalivas
M M
MM
Webb-Peploe
D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D003097:Collateral Circulation / Q000502:physiology; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011475:Prosthesis Failure; D012372:ROC Curve; D012039:Regional Blood Flow / Q000502:physiology; D015607:Stents; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional