[Coronary artery dissection following angioplasty evaluated by fractional flow reserve: report of three cases].
Fractional flow reserve was measured in three patients with coronary artery dissection occurring after percutaneous coronary intervention. In Case 1, fractional flow reserve decreased from 0.88 to 0.73 and angiography showed coronary artery dissection 20 min after balloon angioplasty. In Case 2, angiography showed good results, but the fractional flow reserve decreased to a low value(0.69). Intravascular ultrasonography revealed dissection. In Case 3, angiography clearly showed dissection, but fractional flow reserve remained high(0.91). Stent implantation was performed in all three patients, but might not have been necessary in Case 3. Dissection with low or diminished fractional flow reserve value may cause a pressure gradient in the true lumen. Stent implantation is necessary in such cases. On the other hand, cases of dissection in which the fractional flow reserve value is maintained may also cause a pressure gradient in true lumen, but stent implantation may not be necessary. Fractional flow reserve measurements may be useful for the assessment of coronary artery dissection and evaluating the indications for stent implantation.
Amaya
K
K
Second Department of Internal Medicine, Tokyo Medical University, Nishishinjuku 6-7-1, Shinjuku-ku, Tokyo 160-0023.
Takazawa
K
K
Tanaka
N
N
Takeda
K
K
Matsuoka
O
O
Kurosu
F
F
Okuaki
K
K
Hiraide
D
D
Yamashina
A
A
D000784:Aortic Dissection / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D003323:Coronary Aneurysm / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D003326:Coronary Circulation; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents