Postocclusional Hyperemia for Fractional Flow Reserve After Percutaneous Coronary Intervention

Circ Cardiovasc Interv. 2017 Dec;10(12):e005674. doi: 10.1161/CIRCINTERVENTIONS.117.005674.

Abstract

Background: Postocclusional hyperemia caused by balloon occlusion is a potential alternative method of inducing hyperemia for measuring post-percutaneous coronary intervention fractional flow reserve (FFR). The aim of this study was to investigate postocclusional hyperemia as a method of inducing hyperemia.

Methods and results: FFR measured by postocclusional hyperemia (FFRoccl) caused by balloon occlusion after percutaneous coronary intervention was compared with FFR measured by drug-induced hyperemia (FFR measured by intravenous ATP; and FFR measured by intracoronary papaverine injection [FFRpap]) in 98 lesions from 98 patients. The hyperemia duration was also measured for FFRoccl and FFRpap. The correlation coefficient between FFRoccl, FFR measured by intravenous ATP (r=0.973; P<0.01), and FFRpap (r=0.975; P<0.01) showed almost identical values to those obtained for the correlation coefficient between FFR measured by intravenous ATP and FFRpap (r=0.967; P<0.01). No clear difference was observed on Bland-Altman analysis. Hyperemia duration was significantly longer with FFRoccl than with FFRpap (70±22 versus 51±25 s; P<0.01).

Conclusions: Strong correlations were found between FFRoccl and FFR measured by intravenous ATP and FFRoccl and FFRpap. Hyperemia caused by FFRoccl was significantly longer than that caused by FFRpap.

Keywords: balloon occlusion; hyperemia; percutaneous coronary intervention.

Publication types

  • Validation Study

MeSH terms

  • Adenosine Triphosphate / administration & dosage
  • Administration, Intravenous
  • Aged
  • Aged, 80 and over
  • Balloon Occlusion* / adverse effects
  • Cardiac Catheterization
  • Collateral Circulation
  • Coronary Angiography
  • Coronary Artery Disease / diagnosis
  • Coronary Artery Disease / physiopathology
  • Coronary Artery Disease / therapy*
  • Drug-Eluting Stents
  • Female
  • Fractional Flow Reserve, Myocardial*
  • Humans
  • Hyperemia / physiopathology*
  • Male
  • Middle Aged
  • Papaverine / administration & dosage
  • Percutaneous Coronary Intervention* / instrumentation
  • Predictive Value of Tests
  • Reproducibility of Results
  • Treatment Outcome
  • Vasodilator Agents / administration & dosage

Substances

  • Vasodilator Agents
  • Adenosine Triphosphate
  • Papaverine