Department of Internal Medicine, Keimyung University College of Medicine, Dongsan Medical Center, Daegu, Korea.
Korean Circ J. 2011 Jun;41(6):304-7. doi: 10.4070/kcj.2011.41.6.304. Epub 2011 Jun 30.
Discrepancy between angiographic percent (%) diameter stenosis and fractional flow reserve (FFR) exists in non-left main bifurcation lesions. The aim of this study was to compare angiographic stenosis severity and FFR in jailed ostial left circumflex artery (LCX) lesions after left main (LM)-to-left anterior descending artery (LAD) crossover stenting.
Twenty-nine (n=29) patients with distal LM or ostial LAD lesions treated by LM-to-LAD crossover stenting were consecutively enrolled. After successful stenting, FFR was measured at the jailed LCX. Additional intervention was performed in lesions with FFR <0.8.
The mean reference diameter of LCX was 3.1±0.4 mm, and percent diameter stenosis after crossover stenting was 56±21%. Angiographically significant stenosis (>50%) at the ostial LCX occurred in 59% (17/29) of cases. Among them, only five (29%) lesions had functional significance, and underwent additional procedure. During follow-up, three patients in the deferral group and two patients in the additional intervention group had target lesion revascularization.
There was a discrepancy between angiographic percent diameter stenosis and FFR in jailed LCX lesions after LM crossover stenting.
在非左主干分叉病变中，血管造影狭窄程度（%）与血流储备分数（FFR）之间存在差异。本研究旨在比较左主干（LM）至左前降支（LAD）交叉支架置入后，左回旋支（LCX）开口部被“拘禁”的病变的血管造影狭窄严重程度和 FFR。
连续纳入 29 例因远端 LM 或开口 LAD 病变而行 LM-LAD 交叉支架置入的患者。在成功支架置入后，测量被“拘禁”的 LCX 的 FFR。对 FFR<0.8 的病变进行进一步介入治疗。
LCX 的参考直径平均为 3.1±0.4mm，交叉支架置入后的直径狭窄率为 56±21%。59%（17/29）的病例出现 LCX 开口处的血管造影狭窄程度>50%（狭窄程度>50%）。其中，仅有 5 例（29%）病变具有功能性意义，并进行了进一步的介入治疗。在随访期间，延迟组的 3 例患者和进一步介入组的 2 例患者发生了靶病变血运重建。
LM 交叉支架置入后，LCX 开口部被“拘禁”的病变的血管造影狭窄程度与 FFR 之间存在差异。
