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Fractional flow reserve (FFR) is useful for predicting restenosis after coronary artery stenting, and intravascular ultrasound (IVUS) findings influencing on FFR value is well known. In this study, we evaluated the characteristics of intravascular ultrasound (IVUS) findings associating with decline of fractional flow reserve (FFR) after superficial femoral artery stenting.
Between January 2014 and May 2016, a total of 47 femoropopliteal lesions underwent measuring of FFR and IVUS after nitinol stent implantation. IVUS findings after stenting was compared between the low post-stenting FFR group (≤ 0.92) and the high post-stenting FFR group (>0.92).
Low-FFR (≦0.92) was detected in 24 femoropopliteal lesions (51.1%). In IVUS findings, minimum stent area (MSA) was significantly smaller (16.1 ± 6.0 vs. 20.1 ± 5.2, P=0.023), residual plaque burden was significantly larger (52.0 ± 14.7 vs. 25.8 ± 14.7, P<0.001), and stent eccentricity defined as minimum stent diameter divided by maximum stent diameter was also significantly poorer (0.73 ± 0.11 vs. 0.81 ± 0.12, P = 0.012) in the low post-stenting FFR group (≤ 0.92). In addition, MSA, residual plaque burden, and stent eccentricity were significantly correlated with FFR value (MSA: r = 0.30, P = 0.042, plaque burden: r = -0.64, P < 0.001, stent symmetry: r = 0.32, P = 0.028). ROC analysis showed residual plaque burden had the highest AUC (0.879, P < 0.001) and best cut-off value to predict low post-stenting FFR (≤ 0.92) was 43 % (sensitivity 0.83, specificity 0.87).
Residual plaque burdem was most significantly associated with low post-stenting FFR in superficiall femoral artery disease.
ENDOVASCULAR: Peripheral Vascular Disease and Intervention