title: Use of fraction flow reserve to predict changes over time in management of superficial femoral artery.
abstract: BACKGROUND
  Peripheral arterial disease is a condition characterized by progressive arterial narrowing, which affects patients' quality of life. The purposes of this study were to (1) establish the feasibility of obtaining peripheral fractional flow reserve (pFFR) in the peripheral vascular circulation, (2) demonstrate an association between baseline pFFR and peak systolic velocity (PSV) measured by duplex ultrasound, and (3) correlate postintervention pFFR with future restenosis using the change in PSV over time as a surrogate.
  
  
  METHODS
  Twenty patients underwent baseline ankle brachial index (ABI) and PSV testing. Pre- and postintervention pFFR was performed. Patients were followed with three ABI and PSV recordings during the 1 year follow-up period. The association between baseline PSV, ABI, and pFFR with changes in PSV over time were explored. Predictors of postprocedural PSV over time were determined.
  
  
  RESULTS
  The baseline translesional-resting ratio was significantly different from the pFFR using adenosine (0.79 ± 0.08 vs. 0.71 ± 0.09, P = 0.01). Baseline PSV was significantly associated with preintervention pFFR (-0.77, P < 0.001). Compared to patients with a postprocedure pFFR > 0.95, patients with a postprocedure pFFR < 0.95 had a significantly more rapid rise in PSV over time (P = 0.009).
  
  
  CONCLUSIONS
  This is the first study to demonstrate that the peripheral vascular bed does respond to vasodilatation thereby supporting the use of pFFR for this procedure. In our study, postintervention pFFR < 0.95 predicted a more rapid increase in PSV over time, which is a reasonably accepted surrogate for restenosis.
authors.affiliation: Division of Cardiology, Department of Medicine, Baystate Medical Center, Springfield, Massachusetts 01199, USA. amir.lotfi@bhs.org
authors.forename: A S
authors.initials: AS
authors.lastname: Lotfi
authors.forename: S K
authors.initials: SK
authors.lastname: Sivalingam
authors.forename: G R
authors.initials: GR
authors.lastname: Giugliano
authors.forename: J
authors.initials: J
authors.lastname: Ashraf
authors.forename: P
authors.initials: P
authors.lastname: Visintainer
mesh_terms: D000241:Adenosine / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D000842:Ankle / Q000098:blood supply; D001783:Blood Flow Velocity / Q000187:drug effects; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000187:drug effects; D005260:Female; D005263:Femoral Artery / Q000187:drug effects*; D006801:Humans; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D014665:Vasodilator Agents; D000241:Adenosine