title: The impact of fractional flow reserve measurement on clinical outcomes after transradial coronary stenting.
abstract: OBJECTIVE
  Fractional flow reserve (FFR) ≥0.96 after stenting correlates well with an optimal stent expansion, but outcomes based on FFR after drug eluting stents (DES) have not been studied. This study sought to investigate the proportion of patients in whom an FFR ≥0.96 can be achieved after transradial stenting using primarily DES and to determine outcomes based on a post-stent FFR ≥0.96 vs. an FFR<0.96.
  
  
  RESULTS
  A total of 66 patients with single-vessel disease and FFR<0.75 underwent transradial stenting. After stenting, FFR was <0.96 in 34 patients and there was a hyperaemic trans-stent gradient across the edges of stent in five patients; after high-pressure balloon inflation, FFR increased to ≥0.96 in three patients and an FFR ≥0.96 was achieved in 35 patients (53%, group 1), but FFR remained <0.96 in 31 patients (47%, group 2). There was no correlation between FFR and minimum lumen diameter in group 1 or group 2 (r=0.03; p=0.72 and r=0.02; p=0.22, respectively). The 24-month event-free survival estimate defined as freedom from death, MI, and target vessel revascularisation (PCI or CABG) was significantly greater in group 1 than in group 2 (94% versus 72%, respectively; p=0.02).
  
  
  CONCLUSIONS
  After transradial stenting with predominately DES, an FFR ≥0.96 was achieved in only 53% of patients and event rates among patients with a post-stent FFR ≥0.96 were significantly lower than those with an FFR<0.96.
authors.affiliation: Division of Cardiovascular Diseases, University of Cincinnati, Cincinnati, OH 45267-0542, USA. leesarma@uc.edu
authors.forename: Massoud A
authors.initials: MA
authors.lastname: Leesar
authors.forename: Aaron
authors.initials: A
authors.lastname: Satran
authors.forename: Venkata
authors.initials: V
authors.lastname: Yalamanchili
authors.forename: Tarek
authors.initials: T
authors.lastname: Helmy
authors.forename: Mohammad
authors.initials: M
authors.lastname: Abdul-Waheed
authors.forename: Nattawut
authors.initials: N
authors.lastname: Wongpraparut
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D008297:Male; D008875:Middle Aged; D017534:Radial Artery; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional