Author + information
- Jose M. de la Torre Hernandez,
- Ramon Lopez Palop,
- Tamara Garcia Camarero,
- Pliar Carrillo,
- Gonzalo Martin Gorria,
- Araceli Frutos,
- Blanca Arnaez,
- Julian Roldan,
- Dae–Hyun Lee,
- Fermin Sainz Laso and
- Javier Zueco
Assessment of intermediate coronary lesions can be done with IVUS and FFR. There are not randomized trials comparing these strategies. There are small registries from the same center but subjected to important biases.
:ln two institutions the strategy for intermediate lesion evaluation has been based in IVUS and FFR respectively. We have compared the outcome of patients with intermediate lesions (40–60%) assessed in 2004–2009 in both centers. The criteria for revascularization was FFR < 0,75 and a minimum lumen area < 4mm2in vessels ≥3 mm and < 3.5 mm2in vessels 2.5–3 mm both with plaque burden over 60%.
In the FFR center 400 patients were included (463 lesions). In the IVUS center 530 pts were included (653 lesions). In order to minimize the biases we performed a propensity score matching obtaining 400 matched patients in IVUS group for every FFR case. After FFR measurement, 72% of lesions were left untreated. After IVUS examination, 49% of lesions were left untreated (p< 0.001 vs. FFR center). The clinical and angiographic profile of both groups was well balanced without significant differences. Clinical outcomes at two years follow up are shown in table.
The assessment of intermediate lesions with IVUS induces a higher degree of revascularization. At two years follow up, both strategies result safe with a very low rate of lesion–related events in deferred cases, no infarctions related with target lesion and only a 1.5–3% of target lesion revascularization.
|FFR group n=400||IVUS group n=400|
|Target lesion MI||0.25%||0.25%||1|
|Target lesion MI||0||0||1|
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.–10:30 a.m.
Session Title: Physiological Assessment
Abstract Category: 38. TCT@ACC–i2: Intravascular Imaging and Physiology
Presentation Number: 2107–229
- 2013 American College of Cardiology Foundation