Prospective Evaluation of the Impact of Side-Holes and Guide-Catheter Disengagement From the Coronary Ostium on Fractional Flow Reserve Measurements.
BACKGROUND
We prospectively examined the impact of side-holes and guide-catheter disengagement on fractional flow reserve (FFR) measurements.


METHODS
Twenty-five patients undergoing clinically indicated FFR measurement for intermediate coronary artery stenosis were enrolled. Four FFR measurements were made in random order during intravenous adenosine infusion with: (a) an engaged side-hole guide catheter; (b) a disengaged side-hole guide catheter; (c) an engaged non-side-hole guide catheter; and (d) disengaged non-side-hole guide catheter.


RESULTS
Mean patient age was 65 ± 9 years and 100% were men. The mean distal poststenotic pressure/proximal aortic pressure (Pd/Pa) at baseline was 0.93 ± 0.05 mm Hg. Using intravenous adenosine infusion, the mean FFR measured with engaged vs disengaged non-side-hole guide catheters was 0.87 ± 0.09 vs 0.83 ± 0.10, respectively (mean difference, 0.039 ± 0.04; P<.001). The mean FFR with engaged vs disengaged side-hole guide catheters was 0.85 ± 0.10 vs 0.83 ± 0.10 (mean difference, 0.020 ± 0.02; P<.001). The mean difference in FFR measurements was 0.024 ± 0.03 (P<.001) among engaged guide catheters and 0.005 ± 0.03 (P=.47) among disengaged guide catheters.


CONCLUSIONS
When FFR measurements are performed with engaged guide catheters, side-hole catheters provide lower measurements. When FFR measurements are obtained with disengaged guide catheters, they are even lower and similar between guide catheter types.
Krishna S
KS
Patel
Georgios E
GE
Christakopoulos
Aris
A
Karatasakis
Barbara Anna
BA
Danek
Phuong-Khanh J
PK
Nguyen-Trong
Suwetha
S
Amsavelu
Jeffrey F
JF
Stetler
Bavana V
BV
Rangan
Michele
M
Roesle
Shuaib
S
Abdullah
Tayo
T
Addo
Subhash
S
Banerjee
Dallas VA Medical Center (111A), 4500 South Lancaster Road, Dallas, TX 75216 USA. esbrilakis@gmail.com.
Emmanouil S
ES
Brilakis
D000368:Aged; D062186:Arterial Pressure / Q000187:drug effects / Q000502:physiology; D001783:Blood Flow Velocity / Q000502:physiology; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods; D017023:Coronary Angiography / Q000379:methods; D023921:Coronary Stenosis / Q000175:diagnosis*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D061827:Dimensional Measurement Accuracy; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D006940:Hyperemia / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D062666:Vascular Access Devices