Physiological evaluation of the provisional side-branch intervention strategy for bifurcation lesions using fractional flow reserve.
OBJECTIVE
This study was performed to evaluate the functional outcomes of fractional flow reserve (FFR)-guided jailed side-branch (SB) intervention strategy.


RESULTS
One hundred and ten patients treated by provisional strategy were consecutively enrolled and SB FFR was measured in 91 patients. SB intervention was allowed when FFR was <0.75. FFR measurement was repeated after SB intervention and at 6-month follow-up angiography. In 26 of 28 SB lesions with FFR <0.75, balloon angioplasty (SB balloon/artery ratio = 0.84 +/- 0.14) was performed and FFR >or=0.75 was achieved in 92% of the lesions although the mean residual stenosis was 69 +/- 10%. During follow-up, there were no changes in SB FFR in lesions with (0.86 +/- 0.05 to 0.84 +/- 0.01, P = 0.4) and without SB angioplasty (0.87 +/- 0.06 to 0.89 +/- 0.07, P = 0.1). Functional restenosis (FFR <0.75) rate was only 8% (5/65). When clinical outcomes of these patients were compared with 110 patients with similar bifurcation lesions treated without FFR-guidance, there was no difference in 9-month cardiac event rates (4.6 vs. 3.7%, P = 0.7) between the two groups.


CONCLUSIONS
In conclusion, FFR-guided SB intervention strategy resulted in good functional outcomes.
Koo
Bon-Kwon
BK
Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Yongon-dong 28, Jongno-gu, Seoul 110-744, Republic of Korea.
Park
Kyung-Woo
KW
Kang
Hyun-Jae
HJ
Cho
Young-Seok
YS
Chung
Woo-Young
WY
Youn
Tae-Jin
TJ
Chae
In-Ho
IH
Choi
Dong-Ju
DJ
Tahk
Seung-Jae
SJ
Oh
Byung-Hee
BH
Park
Young-Bae
YB
Kim
Hyo-Soo
HS
D002404:Catheterization; D023921:Coronary Stenosis / Q000188:drug therapy / Q000503:physiopathology*; D016757:Death, Sudden, Cardiac / Q000209:etiology; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D053805:Fractional Flow Reserve, Myocardial / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D009204:Myocardial Revascularization / Q000706:statistics & numerical data; D016896:Treatment Outcome