Latvian Center of Cardiology, Paul Stradins Clinical Hospital, Riga, Latvia.
EuroIntervention. 2012 Feb;7(10):1155-61. doi: 10.4244/EIJV7I10A186.
The substudy was performed to evaluate the acute and eight-month follow-up effect of final kissing balloon dilatation (FKBD) on fractional flow reserve (FFR) in the side branch (SB) after main vessel (MV) stenting.
We included 75 patients in the Nordic-Baltic Bifurcation Study III FFR substudy: 42 in the FKBD group and 33 in the no-FKBD group. Complete angiographic and FFR eight-month follow-up was obtained in 25 (60%) patients in the FKBD group and 21 (63%) patients in the no-FKBD group. In the FKBD group the post-PCI mean SB FFR was significantly higher compared to the no-FKBD group (0.92 vs. 0.85, respectively; p=0.011). No significant difference in FFR value between treatments was detected at eight-month follow-up (0.91 vs. 0.87; p=0.19). There were no significant changes in mean SB FFR during the follow-up period (0.92 vs. 0.91; p=0.80) in the FKBD group and (0.87 vs. 0.87; p=0.91) in the no-FKBD group.
FKBD in simple stenting of bifurcation lesions improved acute functional outcome in SB compared to leaving the SB jailed. No significant difference was detected at follow-up. In both groups there was no significant functional late loss during follow-up. Thus, both strategies were equally effective in ensuring that side branch jailing would not cause ischaemia in the long term.
本亚组研究旨在评估主血管(MV)支架置入后最终球囊扩张(FKBD)对边支(SB)的急性和 8 个月随访时的血流储备分数(FFR)的影响。
我们纳入了 Nordic-Baltic Bifurcation Study III FFR 亚组的 75 例患者:FKBD 组 42 例,无 FKBD 组 33 例。FKBD 组中有 25 例(60%)和无 FKBD 组中有 21 例(63%)患者获得了完整的血管造影和 8 个月的 FFR 随访。FKBD 组 PCI 后 SB 的平均 FFR 明显高于无 FKBD 组(分别为 0.92 与 0.85;p=0.011)。在 8 个月的随访中,两种治疗方法的 FFR 值无显著差异(0.91 与 0.87;p=0.19)。FKBD 组在随访期间 SB 的平均 FFR 无显著变化(0.92 与 0.91;p=0.80),无 FKBD 组也无显著变化(0.87 与 0.87;p=0.91)。
与边支(SB)留滞(jailed)相比,在简单分叉病变支架置入中进行 FKBD 可改善 SB 的急性功能结局。在随访时未发现明显差异。在两组中,随访期间均未出现明显的功能晚期丢失。因此,这两种策略在确保边支留滞不会导致长期缺血方面同样有效。