Zhao Han, Ren Yanlong, Li Jiang, Zhang Mingduo, Zhang Lijun, Chen Rongliang, Liu Jia, Yan Zhengzheng, Song Xiantao
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
J Cardiovasc Dev Dis. 2025 Sep 22;12(9):373. doi: 10.3390/jcdd12090373.
With the advancement of fractional flow reserve (FFR) derived from computed tomography (FFR), virtual stenting technology has gradually developed. This study investigated the performance of virtual stenting based on FFR in predicting post-percutaneous coronary intervention (PCI) FFR. Data from 75 patients (78 blood vessels) was collected retrospectively. We randomly allocated the participants to discovery ( = 26) and validation ( = 52) cohorts. The FFR was calculated using pre-PCI coronary computed tomography angiography images. Virtual stent implantation was simulated using blinded and non-blinded virtual stenting methods to obtain post-virtual stenting FFR. The median FFR before PCI and invasive FFR were 0.70 (0.60-0.77) and 0.69 (0.63-0.76), respectively. The median FFR were 0.91 (0.86-0.95) and 0.91 (0.87-0.94) in the blinded and non-blinded groups, respectively; the invasive post-PCI FFR was 0.90 (0.88-0.93). The difference between the FFR after using the blinded/non-blinded method and the invasive post-PCI FFR were 0.010 (95% limits of agreement: -0.064 to 0.084) and 0.009 (-0.050 to 0.068) in the discovery cohort and -0.005 (-0.075 to 0.064) and -0.0002 (-0.064 to 0.064) in the validation cohort, respectively. Virtual stenting technology based on FFR can effectively predict functional outcomes after PCI and could be a reliable tool for PCI procedural planning.
随着基于计算机断层扫描的血流储备分数（FFRCT）的发展，虚拟支架技术逐渐兴起。本研究旨在探讨基于FFRCT的虚拟支架技术预测经皮冠状动脉介入治疗（PCI）术后FFR的性能。回顾性收集了75例患者（78条血管）的数据。我们将参与者随机分配至发现队列（n = 26）和验证队列（n = 52）。使用PCI术前冠状动脉计算机断层扫描血管造影图像计算FFR。采用盲法和非盲法虚拟支架置入方法模拟虚拟支架植入，以获得虚拟支架置入后的FFR。PCI术前FFR中位数和有创FFR分别为0.70（0.60 - 0.77）和0.69（0.63 - 0.76）。盲法组和非盲法组的FFR中位数分别为0.91（0.86 - 0.95）和0.91（0.87 - 0.94）；PCI术后有创FFR为0.90（0.88 - 0.93）。在发现队列中，盲法/非盲法使用后FFR与PCI术后有创FFR的差异分别为0.010（95%一致性界限：-0.064至0.084）和0.009（-0.050至0.068），在验证队列中分别为-0.005（-0.075至0.064）和-0.0002（-0.064至0.064）。基于FFRCT的虚拟支架技术能够有效预测PCI术后的功能结局，并且可能成为PCI手术规划的可靠工具。
