Published in:
01-04-2020 | Original Article
Post-occlusional hyperemia for fractional flow reserve assessment and pull-back curve analysis
Authors:
T. Hirata, T. Tanigaki, Y. Kawase, A. Hirakawa, H. Omori, S. Okamoto, H. Ota, Y. Sobue, J. Kikuchi, M. Okubo, H. Kamiya, M. Kawasaki, T. Suzuki, N. H. J. Pijls, H. Matsuo
Published in:
Cardiovascular Intervention and Therapeutics
|
Issue 2/2020
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Abstract
Balloon occlusion is a potential method for inducing hyperemia to measure post-percutaneous coronary intervention (PCI) fractional flow reserve (FFR). The objective of this study was to determine the clinical usefulness of post-occlusional hyperemia. FFRs measured using post-occlusional hyperemia caused by 30 (FFRoccl30) and 60 s (FFRoccl60) of balloon occlusion after PCI were compared in 60 lesions from 60 patients. The duration of hyperemia was also measured. There was a strong correlation between FFRoccl30 and FFRoccl60 (r = 0.969, p < 0.01). The duration of hyperemia was significantly longer with FFRoccl60 than with FFRoccl30 (68 ± 23 vs. 37 ± 15 s, p < 0.01). The time required for pullback curve analysis was around 45 s. However, in 7 (12%) cases, the duration of hyperemia with FFRoccl60 was < 45 s, which was not enough for pull-back curve analysis. To predict the duration of hyperemia with FFRoccl60 ≥ 45 s, the receiver operating characteristic curve analysis revealed a cut-off value of 25 s of hyperemia with FFRoccl30. FFRoccl30 is sufficient for diagnostic purposes. FFRoccl60 is suitable for pull-back curve analysis in select cases based on predictions made using the duration of hyperemia with FFRoccl30.