Validation of post-stenting fractional flow reserve with intravascular ultrasound parameters for optimal stent deployment

Sung Gyun Ahn, Soonchang Hong, Jung Woo Son, Jun Won Lee, Young Jin Youn, Min Soo Ahn, Jang Young Kim, Byung Su Yoo, Seung Hwan Lee, Junghan Yoon

Research output: Contribution to journalArticle

Abstract

We aimed to evaluate the relationship between post-stent fractional flow reserve (FFR) and intravascular ultrasound (IVUS) parameters for stent optimization. IVUS and FFR measurements were performed in 101 coronary lesions after successful percutaneous coronary intervention (PCI). Quantitative IVUS parameters for stent optimization such as minimal intra-stent cross sectional area (CSA), proximal, and distal reference lumen CSA, and plaque burden (PB) at both edges of the stent related to the post-stent FFR. Mean post-stent FFR was 0.91 ± 0.06. Post-stent FFR ≤ 0.90 was observed in 46 (45.5%) lesions. The 55 lesions with post-stent FFR > 0.9 had larger proximal CSA (9.2 ± 2.9 mm2 vs. 7.4 ± 2.3 mm2, p = 0.001), distal reference lumen CSA (7.4 ± 2.7 mm2 vs. 6.3 ± 2.1 mm2, p = 0.017), minimum intra-stent lumen CSA (7.4 ± 2.5 mm2 vs. 6.1 ± 1.7 mm2, p = 0.004), and lower proximal reference PB (45 ± 8.2% vs. 50 ± 11%, p = 0.017) than did those with post-stent FFR ≤ 0.90. Post-stent FFR had an inverse correlation with age, left anterior descending artery (LAD) against non-LAD, and proximal reference PB and a positive correlation with pre-stent FFR, proximal and distal reference lumen CSA, and minimum intra-stent lumen CSA. Meanwhile, no correlation was found between post-stent FFR and stent length. Pre-stent FFR (β = 0.544), proximal reference lumen CSA (β = 0.530) and age (β = − 0.251) were found to be independently associated with the post-stent FFR. Post-procedural FFR might partly reflect the appropriateness of PCI results in terms of the adequate expansion of the stent and full lesion coverage on IVUS.

Original languageEnglish
JournalInternational Journal of Cardiovascular Imaging
DOIs
Publication statusAccepted/In press - 2019 Jan 1

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Stents
Percutaneous Coronary Intervention
Arteries

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{abae21dddeb04b8ba53869210e561ab3,
title = "Validation of post-stenting fractional flow reserve with intravascular ultrasound parameters for optimal stent deployment",
abstract = "We aimed to evaluate the relationship between post-stent fractional flow reserve (FFR) and intravascular ultrasound (IVUS) parameters for stent optimization. IVUS and FFR measurements were performed in 101 coronary lesions after successful percutaneous coronary intervention (PCI). Quantitative IVUS parameters for stent optimization such as minimal intra-stent cross sectional area (CSA), proximal, and distal reference lumen CSA, and plaque burden (PB) at both edges of the stent related to the post-stent FFR. Mean post-stent FFR was 0.91 ± 0.06. Post-stent FFR ≤ 0.90 was observed in 46 (45.5{\%}) lesions. The 55 lesions with post-stent FFR > 0.9 had larger proximal CSA (9.2 ± 2.9 mm2 vs. 7.4 ± 2.3 mm2, p = 0.001), distal reference lumen CSA (7.4 ± 2.7 mm2 vs. 6.3 ± 2.1 mm2, p = 0.017), minimum intra-stent lumen CSA (7.4 ± 2.5 mm2 vs. 6.1 ± 1.7 mm2, p = 0.004), and lower proximal reference PB (45 ± 8.2{\%} vs. 50 ± 11{\%}, p = 0.017) than did those with post-stent FFR ≤ 0.90. Post-stent FFR had an inverse correlation with age, left anterior descending artery (LAD) against non-LAD, and proximal reference PB and a positive correlation with pre-stent FFR, proximal and distal reference lumen CSA, and minimum intra-stent lumen CSA. Meanwhile, no correlation was found between post-stent FFR and stent length. Pre-stent FFR (β = 0.544), proximal reference lumen CSA (β = 0.530) and age (β = − 0.251) were found to be independently associated with the post-stent FFR. Post-procedural FFR might partly reflect the appropriateness of PCI results in terms of the adequate expansion of the stent and full lesion coverage on IVUS.",
author = "Ahn, {Sung Gyun} and Soonchang Hong and Son, {Jung Woo} and Lee, {Jun Won} and Youn, {Young Jin} and Ahn, {Min Soo} and Kim, {Jang Young} and Yoo, {Byung Su} and Lee, {Seung Hwan} and Junghan Yoon",
year = "2019",
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doi = "10.1007/s10554-019-01712-8",
language = "English",
journal = "International Journal of Cardiovascular Imaging",
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Validation of post-stenting fractional flow reserve with intravascular ultrasound parameters for optimal stent deployment. / Ahn, Sung Gyun; Hong, Soonchang; Son, Jung Woo; Lee, Jun Won; Youn, Young Jin; Ahn, Min Soo; Kim, Jang Young; Yoo, Byung Su; Lee, Seung Hwan; Yoon, Junghan.

In: International Journal of Cardiovascular Imaging, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Validation of post-stenting fractional flow reserve with intravascular ultrasound parameters for optimal stent deployment

AU - Ahn, Sung Gyun

AU - Hong, Soonchang

AU - Son, Jung Woo

AU - Lee, Jun Won

AU - Youn, Young Jin

AU - Ahn, Min Soo

AU - Kim, Jang Young

AU - Yoo, Byung Su

AU - Lee, Seung Hwan

AU - Yoon, Junghan

PY - 2019/1/1

Y1 - 2019/1/1

N2 - We aimed to evaluate the relationship between post-stent fractional flow reserve (FFR) and intravascular ultrasound (IVUS) parameters for stent optimization. IVUS and FFR measurements were performed in 101 coronary lesions after successful percutaneous coronary intervention (PCI). Quantitative IVUS parameters for stent optimization such as minimal intra-stent cross sectional area (CSA), proximal, and distal reference lumen CSA, and plaque burden (PB) at both edges of the stent related to the post-stent FFR. Mean post-stent FFR was 0.91 ± 0.06. Post-stent FFR ≤ 0.90 was observed in 46 (45.5%) lesions. The 55 lesions with post-stent FFR > 0.9 had larger proximal CSA (9.2 ± 2.9 mm2 vs. 7.4 ± 2.3 mm2, p = 0.001), distal reference lumen CSA (7.4 ± 2.7 mm2 vs. 6.3 ± 2.1 mm2, p = 0.017), minimum intra-stent lumen CSA (7.4 ± 2.5 mm2 vs. 6.1 ± 1.7 mm2, p = 0.004), and lower proximal reference PB (45 ± 8.2% vs. 50 ± 11%, p = 0.017) than did those with post-stent FFR ≤ 0.90. Post-stent FFR had an inverse correlation with age, left anterior descending artery (LAD) against non-LAD, and proximal reference PB and a positive correlation with pre-stent FFR, proximal and distal reference lumen CSA, and minimum intra-stent lumen CSA. Meanwhile, no correlation was found between post-stent FFR and stent length. Pre-stent FFR (β = 0.544), proximal reference lumen CSA (β = 0.530) and age (β = − 0.251) were found to be independently associated with the post-stent FFR. Post-procedural FFR might partly reflect the appropriateness of PCI results in terms of the adequate expansion of the stent and full lesion coverage on IVUS.

AB - We aimed to evaluate the relationship between post-stent fractional flow reserve (FFR) and intravascular ultrasound (IVUS) parameters for stent optimization. IVUS and FFR measurements were performed in 101 coronary lesions after successful percutaneous coronary intervention (PCI). Quantitative IVUS parameters for stent optimization such as minimal intra-stent cross sectional area (CSA), proximal, and distal reference lumen CSA, and plaque burden (PB) at both edges of the stent related to the post-stent FFR. Mean post-stent FFR was 0.91 ± 0.06. Post-stent FFR ≤ 0.90 was observed in 46 (45.5%) lesions. The 55 lesions with post-stent FFR > 0.9 had larger proximal CSA (9.2 ± 2.9 mm2 vs. 7.4 ± 2.3 mm2, p = 0.001), distal reference lumen CSA (7.4 ± 2.7 mm2 vs. 6.3 ± 2.1 mm2, p = 0.017), minimum intra-stent lumen CSA (7.4 ± 2.5 mm2 vs. 6.1 ± 1.7 mm2, p = 0.004), and lower proximal reference PB (45 ± 8.2% vs. 50 ± 11%, p = 0.017) than did those with post-stent FFR ≤ 0.90. Post-stent FFR had an inverse correlation with age, left anterior descending artery (LAD) against non-LAD, and proximal reference PB and a positive correlation with pre-stent FFR, proximal and distal reference lumen CSA, and minimum intra-stent lumen CSA. Meanwhile, no correlation was found between post-stent FFR and stent length. Pre-stent FFR (β = 0.544), proximal reference lumen CSA (β = 0.530) and age (β = − 0.251) were found to be independently associated with the post-stent FFR. Post-procedural FFR might partly reflect the appropriateness of PCI results in terms of the adequate expansion of the stent and full lesion coverage on IVUS.

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