title: Fractional flow reserve versus angiography in left circumflex ostial intervention after left main crossover stenting.
abstract: OBJECTIVE
  Discrepancy between angiographic percent (%) diameter stenosis and fractional flow reserve (FFR) exists in non-left main bifurcation lesions. The aim of this study was to compare angiographic stenosis severity and FFR in jailed ostial left circumflex artery (LCX) lesions after left main (LM)-to-left anterior descending artery (LAD) crossover stenting.
  
  
  METHODS
  Twenty-nine (n=29) patients with distal LM or ostial LAD lesions treated by LM-to-LAD crossover stenting were consecutively enrolled. After successful stenting, FFR was measured at the jailed LCX. Additional intervention was performed in lesions with FFR <0.8.
  
  
  RESULTS
  The mean reference diameter of LCX was 3.1±0.4 mm, and percent diameter stenosis after crossover stenting was 56±21%. Angiographically significant stenosis (>50%) at the ostial LCX occurred in 59% (17/29) of cases. Among them, only five (29%) lesions had functional significance, and underwent additional procedure. During follow-up, three patients in the deferral group and two patients in the additional intervention group had target lesion revascularization.
  
  
  CONCLUSIONS
  There was a discrepancy between angiographic percent diameter stenosis and FFR in jailed LCX lesions after LM crossover stenting.
authors.affiliation: Department of Internal Medicine, Keimyung University College of Medicine, Dongsan Medical Center, Daegu, Korea.
authors.forename: Chang-Wook
authors.initials: CW
authors.lastname: Nam
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Hur
authors.forename: Bon-Kwon
authors.initials: BK
authors.lastname: Koo
authors.forename: Joon Hyung
authors.initials: JH
authors.lastname: Doh
authors.forename: Yun-Kyeong
authors.initials: YK
authors.lastname: Cho
authors.forename: Hyoung-Seob
authors.initials: HS
authors.lastname: Park
authors.forename: Hyuck-Jun
authors.initials: HJ
authors.lastname: Yoon
authors.forename: Hyungseop
authors.initials: H
authors.lastname: Kim
authors.forename: In-Sung
authors.initials: IS
authors.lastname: Chung
authors.forename: Yoon-Nyun
authors.initials: YN
authors.lastname: Kim
authors.forename: William F
authors.initials: WF
authors.lastname: Fearon
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Tahk
authors.forename: Kwon-Bae
authors.initials: KB
authors.lastname: Kim