title: Measuring Procedure and Maximal Hyperemia in the Assessment of Fractional Flow Reserve for Superficial Femoral Artery Disease.
abstract: OBJECTIVE
  The optimal fractional flow reserve (FFR) measurement method for superficial femoral artery (SFA) lesions remains to be established. We clarified the optimal measuring procedure for FFR for SFA lesions and investigated the necessary dose of papaverine for inducing maximal hyperemia in SFA lesions.
  
  
  METHODS
  Forty-eight patients with SFA lesions who underwent measurement of peripheral FFR (pFFR: distal mean pressure divided by proximal mean pressure) after endovascular treatment by the contralateral femoral crossover approach were prospectively enrolled. In the pFFR measurement, a guide sheath was placed on top of the common iliac bifurcation and pressure equalization was performed. After advancing the pressure wire distal to the SFA lesion, sequential papaverine administration selectively to the affected common iliac artery was performed.
  
  
  RESULTS
  There were no symptoms, electrocardiogram changes, and significant pressure drops at the guide sheath tip with increasing papaverine dose. pFFR changes following 20, 30, and 40 mg of papaverine were 0.87±0.10, 0.84±0.10, and 0.84±0.10, respectively (P＜0.001). Although not significantly different, pFFR decreased more in several patients at 30 mg of papaverine than at 20 mg. The pFFR at 40 mg of papaverine was almost similar to that at 30 mg of papaverine. The necessary papaverine dose was not changed according to sex and number of run-off vessels.
  
  
  CONCLUSIONS
  The contralateral femoral crossover approach is useful in FFR measurement for SFA lesions, and maximal hyperemia is induced by 30 mg of papaverine.
authors: Department of Cardiology Saiseikai Yokohama-city Eastern Hospital.
authors: Norihiro
authors: N
authors: Kobayashi
authors: Keisuke
authors: K
authors: Hirano
authors: Masatsugu
authors: M
authors: Nakano
authors: Yoshiaki
authors: Y
authors: Ito
authors: Tsuyoshi
authors: T
authors: Sakai
authors: Hiroshi
authors: H
authors: Ishimori
authors: Masahiro
authors: M
authors: Yamawaki
authors: Motoharu
authors: M
authors: Araki
authors: Reiko
authors: R
authors: Tsukahara
authors: Toshiya
authors: T
authors: Muramatsu
mesh_terms: D000368:Aged; D002309:Cardiology / Q000379:methods*; D023921:Coronary Stenosis / Q000175:diagnosis; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology*; D006333:Heart Failure; D006801:Humans; D006940:Hyperemia / Q000628:therapy*; D007083:Iliac Artery / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010208:Papaverine / Q000627:therapeutic use; D011312:Pressure; D011446:Prospective Studies; D014652:Vascular Diseases / Q000188:drug therapy*; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D014665:Vasodilator Agents; D010208:Papaverine