Haemodynamic significance of ostial side branch nipping following percutaneous intervention at bifurcations: a pressure wire pilot study

Bellenger, Nicholas G.; Swallow, Rosie; Wald, David S; Court, Ismael; Calver, Alison; Dawkins, Keith D.; Curzen, Nick

doi:10.1136/hrt.2006.088690

Cited by 18 publications

(8 citation statements)

References 7 publications

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“…Conventional QCA analysis has overestimated DS of the side branch because of the discrepancy in vessel size proximal and distal to the carina (stepdown phenomenon) when compared with dedicated bifurcation QCA (20). Therefore, DS of the current study tends to be lower than that of previous studies (9,10,12,21). In addition, a recent study demonstrated that dedicated bifurcation QCA was better correlated with the functional significance of the side branch (6).…”

Section: Discussioncontrasting

confidence: 69%

Functional Assessment of Jailed Side Branches in Coronary Bifurcation Lesions Using Fractional Flow Reserve

Ahn

Lee

Kang

et al. 2012

JACC: Cardiovascular Interventions

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Section: Discussioncontrasting

confidence: 69%

Functional Assessment of Jailed Side Branches in Coronary Bifurcation Lesions Using Fractional Flow Reserve

Ahn

Lee

Kang

et al. 2012

JACC: Cardiovascular Interventions

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“…3) and it can be applied to all bifurcation lesions regardless of vessel size and amount of viable myocardium. Previous studies showed the feasibility and safety of using a pressure wire for SB access and SB interventions 6,7,11 . However, jailing of a pressure wire between the stent and vessel wall is not recommended.…”

Section: Ffr In Complex Bifurcation Interventionmentioning

confidence: 99%

“…Previous studies showed the feasibility and safety of using a pressure wire for SB access and SB interventions. 6,7,11 However, jailing of a pressure wire between the stent and vessel wall is not recommended.…”

Section: Ffr In Complex Bifurcation Interventionmentioning

confidence: 99%

Physiologic Evaluation of Bifurcation Lesions Using Fractional Flow Reserve

Koo

2009

J Interven Cardiology

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Functional evaluation of bifurcation lesions is more difficult than usual lesions due to their complex anatomy. Angiographic and intravascular ultrasound criteria for main branch intervention cannot be directly applied to side branch lesions due to the difference in underlying lesion characteristics, geometric changes during intervention, and the size of myocardial territory. Fractional flow reserve is a physiologic parameter which reflects both the degree of stenosis and the area of perfusion supplied by a specific coronary artery. The present review will focus on using fractional flow reserve in bifurcation lesions.

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“…However, the decision to intervene the jailed left circumflex coronary artery (LCX) after an LM stent extending into the left anterior descending coronary artery (LAD) is difficult in some cases if based on angiogram alone. Previous studies suggested that measurement of fractional flow reserve (FFR) across jailed side branch lesions prevents unnecessary complex interventions in bifurcation lesions 3-5). However, the safety and efficacy of the same strategy for jailed LCX after LM-to-LAD crossover stenting when a larger amount of myocardium may be in jeopardy remains unvalidated.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies suggested that measurement of fractional flow reserve (FFR) across jailed side branch lesions prevents unnecessary complex interventions in bifurcation lesions. 3 - 5) However, the safety and efficacy of the same strategy for jailed LCX after LM-to-LAD crossover stenting when a larger amount of myocardium may be in jeopardy remains unvalidated. The aim of this study was to compare angiographic stenosis severity and FFR in jailed ostial LCX lesions after LM-to-LAD crossover stenting.…”

Section: Introductionmentioning

confidence: 99%

Fractional Flow Reserve Versus Angiography in Left Circumflex Ostial Intervention After Left Main Crossover Stenting

et al. 2011

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Background and ObjectivesDiscrepancy between angiographic percent (%) diameter stenosis and fractional flow reserve (FFR) exists in non-left main bifurcation lesions. The aim of this study was to compare angiographic stenosis severity and FFR in jailed ostial left circumflex artery (LCX) lesions after left main (LM)-to-left anterior descending artery (LAD) crossover stenting.Subjects and MethodsTwenty-nine (n=29) patients with distal LM or ostial LAD lesions treated by LM-to-LAD crossover stenting were consecutively enrolled. After successful stenting, FFR was measured at the jailed LCX. Additional intervention was performed in lesions with FFR <0.8.ResultsThe mean reference diameter of LCX was 3.1±0.4 mm, and percent diameter stenosis after crossover stenting was 56±21%. Angiographically significant stenosis (>50%) at the ostial LCX occurred in 59% (17/29) of cases. Among them, only five (29%) lesions had functional significance, and underwent additional procedure. During follow-up, three patients in the deferral group and two patients in the additional intervention group had target lesion revascularization.ConclusionThere was a discrepancy between angiographic percent diameter stenosis and FFR in jailed LCX lesions after LM crossover stenting.

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Haemodynamic significance of ostial side branch nipping following percutaneous intervention at bifurcations: a pressure wire pilot study

Cited by 18 publications

References 7 publications

Functional Assessment of Jailed Side Branches in Coronary Bifurcation Lesions Using Fractional Flow Reserve

Functional Assessment of Jailed Side Branches in Coronary Bifurcation Lesions Using Fractional Flow Reserve

Physiologic Evaluation of Bifurcation Lesions Using Fractional Flow Reserve

Fractional Flow Reserve Versus Angiography in Left Circumflex Ostial Intervention After Left Main Crossover Stenting

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