Physiological evaluation of the provisional side-branch intervention strategy for bifurcation lesions using fractional flow reserve
Physiological evaluation of the provisional side-branch intervention strategy for bifurcation lesions using fractional flow reserve
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DOI：
10.1093/eurheartj/ehn045
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发表时间：
2008-03-01
影响因子：
39.3
通讯作者：
Kim, Hyo-Soo
中科院分区：
文献类型：
--
作者：
Koo, Bon-Kwon;Park, Kyung-Woo;Kim, Hyo-Soo
目的：本研究旨在评价血流储备分数（FFR）指导的被监禁侧支（SB）介入策略的功能结局。方法和结果110例患者接受临时策略治疗，91例患者测量SB FFR。当FFR < 0.75时，允许SB干预。在SB干预后和6个月随访血管造影时重复FFR测量。在FFR < 0.75的28处SB病变中，有26处进行了球囊血管成形术（SB球囊/动脉比= 0.84 +/- 0.14），92%的病变实现了FFR >= 0.75，尽管平均残余狭窄为69 +/-10%。随访期间，SB血管成形术（0.86 +/- 0.05至0.84 +/- 0.01，P = 0.4）和非SB血管成形术（0.87 +/- 0.06至0.89 +/- 0.07，P = 0.1）的病变中SB FFR无变化。功能性再狭窄（FFR < 0.75）率仅为8%（5/65）。当这些患者的临床结果与110例类似分叉病变的患者进行比较，没有FFR指导下治疗，有没有9个月的心脏事件率（4.6与3.7%，P = 0.7）之间的两组之间的差异。结论总之，FFR指导下的SB干预策略导致良好的功能结果。
Aims This study was performed to evaluate the functional outcomes of fractional flow reserve (FFR)-guided jailed side-branch (SB) intervention strategy.Methods and results One hundred and ten patients treated by provisional strategy were consecutively enrolled and SB FFR was measured in 91 patients. SB intervention was allowed when FFR was < 0.75. FFR measurement was repeated after SB intervention and at 6-month follow-up angiography. In 26 of 28 SB lesions with FFR < 0.75, balloon angioplasty (SB balloon/artery ratio = 0.84 +/- 0.14) was performed and FFR >= 0.75 was achieved in 92% of the lesions although the mean residual stenosis was 69 +/- 10%. During follow-up, there were no changes in SB FFR in lesions with (0.86 +/- 0.05 to 0.84 +/- 0.01, P = 0.4) and without SB angioplasty (0.87 +/- 0.06 to 0.89 +/- 0.07, P = 0.1). Functional restenosis (FFR < 0.75) rate was only 8% (5/65). When clinical outcomes of these patients were compared with 110 patients with similar bifurcation lesions treated without FFR-guidance, there was no difference in 9-month cardiac event rates (4.6 vs. 3.7%, P = 0.7) between the two groups.Conclusion In conclusion, FFR-guided SB intervention strategy resulted in good functional outcomes.