Post-occlusional hyperemia for fractional flow reserve assessment and pull-back curve analysis

T. Hirata, T. Tanigaki, Y. Kawase, A. Hirakawa, H. Omori, S. Okamoto, H. Ota, Y. Sobue, J. Kikuchi, M. Okubo, H. Kamiya, M. Kawasaki, T. Suzuki, N. H.J. Pijls, H. Matsuo

Research output: Contribution to journalArticle

Abstract

Balloon occlusion is a potential method for inducing hyperemia to measure post-percutaneous coronary intervention (PCI) fractional flow reserve (FFR). The objective of this study was to determine the clinical usefulness of post-occlusional hyperemia. FFRs measured using post-occlusional hyperemia caused by 30 (FFRoccl30) and 60 s (FFRoccl60) of balloon occlusion after PCI were compared in 60 lesions from 60 patients. The duration of hyperemia was also measured. There was a strong correlation between FFRoccl30 and FFRoccl60 (r = 0.969, p < 0.01). The duration of hyperemia was significantly longer with FFRoccl60 than with FFRoccl30 (68 ± 23 vs. 37 ± 15 s, p < 0.01). The time required for pullback curve analysis was around 45 s. However, in 7 (12%) cases, the duration of hyperemia with FFRoccl60 was < 45 s, which was not enough for pull-back curve analysis. To predict the duration of hyperemia with FFRoccl60 ≥ 45 s, the receiver operating characteristic curve analysis revealed a cut-off value of 25 s of hyperemia with FFRoccl30. FFRoccl30 is sufficient for diagnostic purposes. FFRoccl60 is suitable for pull-back curve analysis in select cases based on predictions made using the duration of hyperemia with FFRoccl30.

Original languageEnglish
Pages (from-to)142-149
Number of pages8
JournalCardiovascular Intervention and Therapeutics
Volume35
Issue number2
DOIs
Publication statusPublished - 01-04-2020

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Hirata, T., Tanigaki, T., Kawase, Y., Hirakawa, A., Omori, H., Okamoto, S., Ota, H., Sobue, Y., Kikuchi, J., Okubo, M., Kamiya, H., Kawasaki, M., Suzuki, T., Pijls, N. H. J., & Matsuo, H. (2020). Post-occlusional hyperemia for fractional flow reserve assessment and pull-back curve analysis. Cardiovascular Intervention and Therapeutics, 35(2), 142-149. https://doi.org/10.1007/s12928-019-00579-9