Fractional Flow Reserve: Patient Selection and Perspectives

Peper, Joyce; Becker, Leonie M; Kuijk, Jan-Peter van; Leiner, Tim; Swaans, Martin J.

doi:10.2147/vhrm.s286916

Cited by 5 publications

(2 citation statements)

References 108 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Secondly, for intermediate coronary stenoses (50%-90% diameter reduction), the correlation between anatomical stenosis severity and hemodynamical significance is not straightforward [9]. This is regardless of operator experience or the accuracy of stenosis severity assessment.…”

Section: J Peper Lm Becker Mj Swaansmentioning

confidence: 99%

Apples and oranges in coronary artery disease diagnostics

2023

View full text Add to dashboard Cite

show abstract

Section: J Peper Lm Becker Mj Swaansmentioning

confidence: 99%

Apples and oranges in coronary artery disease diagnostics

2023

View full text Add to dashboard Cite

show abstract

“…Moreover, intravascular modalities are recognized to positively impact the clinical outcomes regarding CAD assessment and PCI guidance ( 10 , 22 ). On the other hand, FFR/iFR remain the guideline-recommended invasive modalities to identify coronary lesions requiring interventional procedures to resolve myocardial ischemia ( 23 , 24 ).…”

Section: Introductionmentioning

confidence: 99%

Multimodality OCT, IVUS and FFR evaluation of coronary intermediate grade lesions in women vs. men

Baruś

Piasecki

Gumiężna

et al. 2023

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

BackgroundThe pathophysiology of atherosclerotic plaque formation and its vulnerability seem to differ between genders due to contrasting risk profiles and sex hormones, however this process is still insufficiently understood. The aim of the study was to compare the differences between sexes regarding the optical coherence tomography (OCT), intravascular ultrasound (IVUS) and fractional flow reserve (FFR)-derived coronary plaque indices.MethodsIn this single-center multimodality imaging study patients with intermediate grade coronary stenoses identified in coronary angiogram (CAG) were evaluated using OCT, IVUS and FFR. Stenoses were considered significant when the FFR value was ≤0.8. Minimal lumen area (MLA), was analyzed by OCT in addition to plaque stratification into fibrotic, calcific, lipidic and thin-cap fibroatheroma (TCFA). IVUS was used for evaluation of lumen-, plaque- and vessel volume, as well as plaque burden.ResultsA total of 112 patients (88 men and 24 women) with chronic coronary syndromes (CCS), who underwent CAG were enrolled. No significant differences in baseline characteristics were present between the study groups. The mean FFR was 0.76 (0.73–0.86) in women and 0.78 ± 0.12 in men (p = 0.695). OCT evaluation showed a higher prevalence of calcific plaques among women than men p = 0.002 whereas lipid plaques were more frequent in men (p = 0.04). No significant differences regarding minimal lumen diameter and minimal lumen area were found between the sexes. In IVUS analysis women presented with significantly smaller vessel area, plaque area, plaque volume, vessel volume (11.1 ± 3.3 mm2 vs. 15.0 ± 4.6 mm2p = 0.001, 6.04 ± 1.7 mm2 vs. 9.24 ± 2.89 mm2p < 0.001, 59.8 ± 35.2 mm3 vs. 96.3 (52.5–159.1) mm3p = 0.005, 106.9 ± 59.8 mm3 vs. 153.3 (103–253.4) mm3p = 0.015 respectively). At MLA site plaque burden was significantly greater for men than women (61.50 ± 7.7% vs. 55.5 ± 8.0% p = 0.005). Survival did not differ significantly between women and men (94.6 ± 41.9 months and 103.51 ± 36.7 months respectively; p = 0.187).ConclusionThe presented study did not demonstrate significant differences in FFR values between women and men, yet a higher prevalence of calcific plaques by OCT and lower plaque burden at the MLA site by IVUS was found in women vs. men.

show abstract

Caught Between Heart and Limbs: Navigating the Treatment of Patients With CAD and PAD in an Overwhelmed Healthcare System

Dabic,

Petrovic,

Vucurevic

et al. 2023

Angiology

View full text Add to dashboard Cite

Peripheral arterial disease (PAD) and coronary artery disease (CAD) are manifestations of atherosclerosis, affecting a substantial proportion of the population. Despite their interrelation, the prevalence of CAD in severe PAD varies, prompting the need to understand their complex relationship. This study retrospectively analyzes prospectively collected data from a high-volume vascular center to assess CAD prevalence, risk factors, and implications for patients undergoing vascular surgery. Among 667 arterial disease patients, 19.5% underwent coronary angiography, with CAD detected in 61.5% of cases. CAD varied across vascular beds. Decision-making around preoperative coronary angiography and revascularization remains complex, with benefits for high-risk patients still being debated. In accordance with current guidelines, the routine practice of coronary revascularization preceding vascular surgery is generally discouraged. This study underscores the need for risk stratification to identify patients who might benefit from coronary revascularization prior to vascular surgery while adhering to cost-effectiveness and avoiding unnecessary and time-consuming diagnostics in the majority of patients. Patient demographics, risk factors, and clinical presentation were analyzed alongside hospital stay, mortality, and complications. The study highlights the challenges in managing patients with concurrent CAD and PAD and calls for improved protocols for treating this high-risk group.

show abstract

Fractional Flow Reserve: Patient Selection and Perspectives

Cited by 5 publications

References 108 publications

Apples and oranges in coronary artery disease diagnostics

Apples and oranges in coronary artery disease diagnostics

Multimodality OCT, IVUS and FFR evaluation of coronary intermediate grade lesions in women vs. men

Caught Between Heart and Limbs: Navigating the Treatment of Patients With CAD and PAD in an Overwhelmed Healthcare System

Contact Info

Product

Resources

About