Comparison of adenosine-independent pressure indices to fractional flow reserve in stent-jailed bifurcation side branches

Altstidl JM, Achenbach S, Marwan M, Tröbs M, Schacher N, Ferstl P, Gerlach A, Schlundt C, Gaede L (2022)

Publication Type: Journal article

Publication year: 2022

Journal

Catheterization and Cardiovascular Interventions Wiley-Blackwell

Abstract

Objectives and Background: This study aims to evaluate whether the high correlation and classification agreement of the instantaneous wave-free ratio (iFR) and the resting distal coronary to aortic pressure ratio (Pd/Pa) with the fractional flow reserve (FFR) can be confirmed in stent-jailed side branches (J-SB). Methods: Consecutive patients (n = 49) undergoing provisional stenting were prospectively enrolled and a physiological assessment of the J-SB (n = 51) was performed. FFR, iFR, and Pd/Pa were measured and the hemodynamic relevance was determined using cutoff values of ≤0.80, ≤0.89, and ≤0.92, respectively. Results: Both iFR (r = 0.75) and Pd/Pa (r = 0.77) correlated closely with FFR. Classification agreement with FFR was 78% for iFR (81% sensitivity, 77% specificity) and 75% for Pd/Pa (63% sensitivity and 80% specificity). However, angiographic diameter stenosis and pressure indices correlated poorly. For a threshold of ≥70% stenosis, agreement concerning hemodynamic relevance was found in 59% for FFR, 69% for iFR, and 61% for Pd/Pa. Conclusion: As reported for other lesion types, FFR and the adenosine-independent pressure indices iFR and Pd/Pa show close correlation and a high classification agreement of approximately 75%–80% in J-SB. Therefore, iFR can be regarded as a recommendable alternative to FFR for the guidance of provisional stenting in bifurcation lesions.

Authors with CRIS profile

Johannes Michael Altstidl Department of Medicine 2 – Cardiology and Angiology Stephan Achenbach Lehrstuhl für Innere Medizin II Mohamed Marwan Department of Medicine 2 – Cardiology and Angiology Monique Tröbs Department of Medicine 2 – Cardiology and Angiology Nora Schacher Department of Medicine 2 – Cardiology and Angiology Paul Ferstl Department of Medicine 2 – Cardiology and Angiology Andreas Gerlach Department of Medicine 2 – Cardiology and Angiology Christian Schlundt Department of Medicine 2 – Cardiology and Angiology Luise Gaede Department of Medicine 2 – Cardiology and Angiology

How to cite

APA:

Altstidl, J.M., Achenbach, S., Marwan, M., Tröbs, M., Schacher, N., Ferstl, P.,... Gaede, L. (2022). Comparison of adenosine-independent pressure indices to fractional flow reserve in stent-jailed bifurcation side branches. Catheterization and Cardiovascular Interventions. https://dx.doi.org/10.1002/ccd.30298

MLA:

Altstidl, Johannes Michael, et al. "Comparison of adenosine-independent pressure indices to fractional flow reserve in stent-jailed bifurcation side branches." Catheterization and Cardiovascular Interventions (2022).

BibTeX: Download