title: FFR result post PCI is suboptimal in long diffuse coronary artery disease.
abstract: OBJECTIVE
  The aim of this study was to evaluate the functional result immediately post PCI and at nine-month follow-up, and to ascertain how often a functionally optimal result of >0.95 can be achieved in long coronary lesions treated with long second- or newer-generation DES.
  
  
  RESULTS
  Patients receiving DES measuring ≥30 mm with FFR value ≤0.8 were included in the study. Stent length was defined as long (30 to 49 mm; L-DES) and ultra-long (≥50 mm; UL-DES). Angiographic and FFR evaluation was performed before and after PCI and at nine-month follow-up. A total of 74 patients each received a mean stent length of 50.72±14.6 mm. Mean FFR post PCI was 0.88±0.06. An optimal post PCI FFR value of >0.95 was achieved in only 9/74 patients (12.2%), and was not achieved in any UL-DES patients. Only 12/74 (16.2%) had FFR post PCI of 0.91 to 0.95; 8/74 (10.8%) patients remained ischaemic (≤0.8). FFR gradient across the stent was higher in UL-DES patients compared to L-DES patients (0.07±0.03 vs. 0.04±0.03; p=0.001). At follow-up, the angiographic restenosis rate was 4.7%, and the functional restenosis rate was 15.1%.
  
  
  CONCLUSIONS
  The FFR result post PCI was suboptimal in the majority of patients treated with long DES and was particularly poor when the total stent length exceeded 50 mm.
authors.affiliation: Vilnius University, Faculty of Medicine, Vilnius, Lithuania.
authors.forename: Arvydas
authors.initials: A
authors.lastname: Baranauskas
authors.forename: Aaron
authors.initials: A
authors.lastname: Peace
authors.forename: Aleksandras
authors.initials: A
authors.lastname: Kibarskis
authors.forename: Joanne
authors.initials: J
authors.lastname: Shannon
authors.forename: Vytautas
authors.initials: V
authors.lastname: Abraitis
authors.forename: Vilhelmas
authors.initials: V
authors.lastname: Bajoras
authors.forename: Valdas
authors.initials: V
authors.lastname: Bilkis
authors.forename: Audrius
authors.initials: A
authors.lastname: Aidietis
authors.forename: Aleksandras
authors.initials: A
authors.lastname: Laucevicius
authors.forename: Giedrius
authors.initials: G
authors.lastname: Davidavicius
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000628:therapy*; D023903:Coronary Restenosis / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D053805:Fractional Flow Reserve, Myocardial / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods; D016896:Treatment Outcome