Comparison of intravenous adenosine to intracoronary papaverine for calculation of pressure-derived fractional flow reserve

Voort, Pepijn H. van der; Hagen, Eduard van; Hendrix, Gert; Gelder, Berry van; Bech, Jan; Pijls, Nico H.J.

doi:10.1002/(sici)1097-0304(199610)39:2<120::aid-ccd3>3.0.co;2-h

Cited by 63 publications

(23 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our results are consistent with pressure changes observed in other studies, which were focused mainly on changes in coronary artery pressure. [8][9][10][11] The fall in Pd pressure after intravenous adenosine is attributable to a combination of a fall in aortic perfusion pressure, in addition to microcirculatory vasodilatation. Using Pr analysis, a close relationship was found between the changes in Pa pressure and changes in large artery compliance and resistance.…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic Response to Intravenous Adenosine and Its Effect on Fractional Flow Reserve Assessment

Tarkin

Nijjer

Sen

et al. 2013

Circ: Cardiovascular Interventions

View full text Add to dashboard Cite

Other landmark studies such as DEFER used both intravenous and intracoronary adenosine, although the frequency of the mode of adenosine administration was not reported. 3 Intravenous adenosine administration is thought to provide the most stable conditions of hyperemia for measurement of FFR. However, even in the best hands, it is possible that Background-We studied the hemodynamic response to intravenous adenosine on calculation of fractional flow reserve (FFR). Intravenous adenosine is widely used to achieve conditions of stable hyperemia for measurement of FFR. However, intravenous adenosine affects both systemic and coronary vascular beds differentially.

show abstract

Section: Discussionmentioning

confidence: 99%

Hemodynamic Response to Intravenous Adenosine and Its Effect on Fractional Flow Reserve Assessment

Tarkin

Nijjer

Sen

et al. 2013

Circ: Cardiovascular Interventions

View full text Add to dashboard Cite

show abstract

“…[5][6][7][8] This method can induce steady-state hyperemia and has more reliable hyperemic efficacy than IC bolus injection [17][18][19] ; however, it requires an additional procedure for femoral vein access and is difficult to use during transradial coronary catheterization procedures. Yoon et al 20 described IC continuous infusion of adenosine through the microcatheter and found that its hyperemic efficacy is comparable to IV infusion of adenosine via the femoral vein; however, this method requires insertion of an additional catheter into the coronary artery, and the catheter itself can reduce the proximal pressure when a small caliber guide catheter is used.…”

Section: Discussionmentioning

confidence: 99%

“…The time to maximal hyperemia (time needed to reach Ͼ90% of the minimal value of Pd/Pa with adenosine infusion) and plateau time (the time hyperemic efficacy remained at Ͼ90% of its maximal value after stopping of adenosine infusion) were also measured. 8 Hyperemic mean transit time was measured using 3 injections of 3 mL of room temperature saline under maximal hyperemia in 20 patients. The index of microcirculatory resistance was calculated as Pd at maximal hyperemia multiplied by the hyperemic mean transit time.…”

Section: Ffr Measurementmentioning

confidence: 99%

“…Continuous intravenous (IV) infusion of adenosine through the femoral vein has been used as a standard method for the induction of hyperemia for FFR measurement [5][6][7][8] ; however, this method needs a large central venous access, which requires additional time, cost, and risk of complication. Moreover, this method is very difficult to use during transradial coronary catheterization procedures, which have become more popular in recent years.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Comparison of Hyperemic Efficacy Between Central and Peripheral Venous Adenosine Infusion for Fractional Flow Reserve Measurement

Seo

Koo

Kim

et al. 2012

Circ: Cardiovascular Interventions

View full text Add to dashboard Cite

Background-Maximal hyperemia is a prerequisite for the accurate measurement of fractional flow reserve (FFR).Although continuous infusion of adenosine via the femoral vein is considered to be the gold standard, this requires an additional invasive procedure for femoral vein access and is difficult to use during transradial coronary catheterization. We performed this prospective study to evaluate the feasibility and efficacy of peripheral intravenous infusion of adenosine for FFR measurement. Methods and Results-Seventy-one patients were prospectively enrolled, and FFR was measured using a 0.014-inch coronary pressure wire. Hyperemic efficacy of adenosine was compared among intracoronary bolus injection and continuous IV infusion (140 g/min/kg) via the femoral and via the forearm vein. In 20 patients, hyperemic mean transit time and index of microcirculatory resistance were also measured. Mean FFR after bolus administration of adenosine was 0.81Ϯ0.

show abstract

“…10,[16][17][18] However, bolus administration of adenosine is sometimes inadequate for the induction of maximal hyperemia, 10,13,14 and the duration of the hyperemia is too short for a pressure pullback maneuver or coronary flow reserve measurement by the thermodilution method. 10,16 Moreover, IV adenosine infusion requires central or large vein access and a large amount of adenosine.…”

Section: Discussionmentioning

confidence: 99%

Intracoronary Continuous Adenosine Infusion A Novel and Effective Way of Inducing Maximal Hyperemia for Fractional Flow Reserve Measurement

Koo

Kim

et al. 2005

Circ J

View full text Add to dashboard Cite

and long procedural time. The present study was performed to assess the safety and efficacy of continuous IC adenosine infusion for the induction of maximal hyperemia for FFR measurement. Methods Patient PopulationPatients with an angiographically intermediate lesion (visual estimation: 50-75%) in a major epicardial coronary artery were prospectively and consecutively enrolled. Clinical and angiographic data are shown in Table 1. There were no patients with angiographically visible collateral flow to the target vessel. Patients with myocardial infarction, unstable clinical condition, regional wall motion ractional flow reserve (FFR) is an easily obtainable lesion-specific parameter for the physiological evaluation of epicardial coronary artery stenosis. This index is relatively independent of systemic blood pressure, heart rate, and contractility and is being increasingly used to assess the functional significance of intermediate lesions and the results of coronary interventions. [1][2][3][4][5][6][7][8] FFR is the ratio of hyperemic flow in the presence of coronary artery stenosis to normal maximal flow, and it can be obtained by the ratio of the hyperemic distal coronary artery pressure to the aortic pressure. 9 Because distal coronary artery pressure is determined by both epicardial stenosis and distal resistance, maximal hyperemia is a key determinant for FFR in a fixed epicardial stenosis. Various pharmacologic stimuli are used to induce maximal hyperemia for FFR measurement; 10-12 however, the usefulness of continuous intracoronary (IC) infusion of adenosine has not been evaluated. Recent reports suggest that bolus adenosine administration is sometimes inadequate for the induction of maximal hyperemia 10,12-14 and intravenous (IV) adenosine infusion requires a large venous access, a large amount of adenosine Intracoronary Continuous Adenosine Infusion A Novel and Effective Way of Inducing Maximal Hyperemia for Fractional Flow Reserve MeasurementBon-Kwon Koo, MD, PhD; Cheol-Ho Kim, MD, PhD*; Sang-Hun Na, MD; Tae-Jin Youn, MD, PhD*; In-Ho Chae, MD, PhD*; Dong-Ju Choi, MD, PhD*; Hyo-Soo Kim, MD, PhD; Myoung-Mook Lee, MD, PhD; Byung-Hee Oh, MD, PhD; Young-Bae Park, MD, PhD; Yun-Shik Choi, MD, PhD; Seung-Jae Tahk, MD, PhD** Background Various methods are used to induce maximal hyperemia for physiologic studies, but the feasibility and efficacy of continuous intracoronary (IC) infusion of adenosine for measurement of fractional flow reserve (FFR) has not been well-defined. Methods and ResultsPatients with intermediate coronary artery stenosis were consecutively enrolled. In the phase I study, FFR was measured after 3 dosages of IC adenosine infusion (180, 240 and 300 g/min) in 30 patients. The phase II study was performed to compare the hyperemic efficacy of IC infusion (240 g/min) with IC bolus injection (40, 80 g) and intravenous (IV) infusion (140 g·kg -1 ·min -1 ) of adenosine in 20 patients. In the phase I study, no significant differences in FFR were observed with the 3 different doses of IC infusion (p=0...

show abstract

Comparison of intravenous adenosine to intracoronary papaverine for calculation of pressure-derived fractional flow reserve

Cited by 63 publications

References 19 publications

Hemodynamic Response to Intravenous Adenosine and Its Effect on Fractional Flow Reserve Assessment

Hemodynamic Response to Intravenous Adenosine and Its Effect on Fractional Flow Reserve Assessment

Comparison of Hyperemic Efficacy Between Central and Peripheral Venous Adenosine Infusion for Fractional Flow Reserve Measurement

Intracoronary Continuous Adenosine Infusion A Novel and Effective Way of Inducing Maximal Hyperemia for Fractional Flow Reserve Measurement

Contact Info

Product

Resources

About