Ability of Fractional Flow Reserve to Predict Restenosis After Superficial Femoral Artery Stenting

Kobayashi, Noboru; Hirano, Keisuke; Yamawaki, Masahiro; Araki, Motoharu; Sakai, Tsuyoshi; Takimura, Hideyuki; Sakamoto, Yasunari; Mori, Shinsuke; Tsutsumi, Masahiro; Takama, Takuro; Honda, Yohsuke; Tokuda, Takahiko; Momose, Kazutaka; Shirai, Shinichi; Ito, Yoshiaki

doi:10.1177/1526602816668306

Cited by 12 publications

(11 citation statements)

References 34 publications

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“…If a significant adjusted mortality difference was found between races, a prespecified mediation analysis was planned to investigate the potential role of variations in procedural and postprocedural care in driving this difference. Procedural and postprocedural factors considered in the analyses included the following: (1) the use of advanced intracoronary imaging or physiologic testing (fractional flow reserve [FFR], 22 intravascular ultrasound [IVUS], 23 or optical coherence tomography [OCT]); (2) bare-metal stent (BMS) vs drug-eluting stent (DES) use; (3) incomplete revascularization; (4) radial access use; and (5) postprocedural medication prescriptions (high-intensity statins, β-blockers, angiotensin-converting enzyme inhibitor [ACEi] or aldosterone receptor blocker [ARB] therapy, and clopidogrel bisulfate, ticagrelor, or prasugrel). Performance of FFR, IVUS, or OCT included the use of this technology during the diagnostic catheterization, PCI, or both.…”

Section: Procedural and Postprocedural Carementioning

confidence: 99%

Comparative Outcomes After Percutaneous Coronary Intervention Among Black and White Patients Treated at US Veterans Affairs Hospitals

et al. 2017

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Section: Procedural and Postprocedural Carementioning

confidence: 99%

Comparative Outcomes After Percutaneous Coronary Intervention Among Black and White Patients Treated at US Veterans Affairs Hospitals

et al. 2017

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“…8,13) In terms of pressure study, FFR ≤0.92 after EVT predicted in-stent restenosis in the SFA. 7) VFR, measured by a thermodilution method after EVT, predicted limb prognosis in critical limb ischemia patients. 14) It is not clear whether pressure- and velocity-based parameters predict limb prognosis, such as lesion restenosis or amputation free survival.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies reported translesional pressure measurement, with pressure sensor wires, to calculate FFR in peripheral arterial diseases. 5–7) In pathophysiological conditions, such as stenosis of the superficial femoral artery (SFA), stenosis resistance may increase, but the relationship between stenosis resistance and stenotic severity remains to be seen. We aimed to elucidate SFA stenosis resistance’s pathophysiological significance at maximal hyperemia.…”

Section: Introductionmentioning

confidence: 99%

Pressure- and Velocity-Based Physiological Assessment of Stenotic Lesions at Hyperemia in Superficial Femoral Artery Disease: Importance of Hyperemic Stenosis Resistance

Ikeoka¹,

Watanabe²,

Shinoda³

et al. 2019

Annals of Vascular Diseases

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Background: In superficial femoral artery (SFA) stenosis, stenosis resistance may increase, but the relationship between stenosis resistance and stenotic severity remains to be seen. This study aimed to investigate the physiological response, through a hyperemic condition, and the pathophysiological significance of Doppler flow and stenosis resistance in SFA.Methods: Twenty-four limbs with focal stenosis of the SFA were analyzed. We assessed the fractional flow reserve (FFR), hyperemic stenosis resistance (h-SR), and vascular flow reserve (VFR) of the SFA with a pressure/Doppler flow sensor-tipped combination guidewire before and after endovascular therapy (EVT).Results: FFR, h-SR, and VFR changed significantly after EVT. h-SR was more strongly correlated with % area stenosis, measured by intravascular ultrasound than FFR (FFR: r=−0.716, h-SR: r=0.741, p<0.0001, respectively). However, VFR was not associated with % area stenosis. A receiver operating characteristic curve showed cut-offs h-SR >0.36 mmHg·sec/cm, and FFR <0.88 predicted >75% area stenosis with area under curves of 0.883 and 0.828, respectively.Conclusion: h-SR can indicate stenotic severity in an SFA focal lesion more prominently than FFR and may be a new physiological index to determine indication for EVT. VFR was not feasible for assessment in SFA focal stenosis.

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“…A post-intervention PFFR of <0.95 was associated with a significant increase in PSV. Later on, Kobayashi et al conducted a single center nonrandomized prospective study to demonstrate the relation of post-intervention PFFR and future risk of restenosis [22]. The authors administered papaverine 30 mg to induce hyperemia and PFFR was measured using 0.014-inch Pressure Wire Aeris G8 (St. Jude Medical).…”

Section: Reviewmentioning

confidence: 99%

The Use of Fractional Flow Reserve for Physiological Assessment of Indeterminate Lesions in Peripheral Artery Disease

Mangi

Kahloon

Elzanaty

et al. 2019

Cureus

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Peripheral artery disease (PAD) is a prevalent disorder in the United States, associated with significant morbidity and mortality. Fractional Flow Reserve (FFR) is a physiological test used to assess the hemodynamic significance of intermediate lesions on conventional angiography. It is well studied in coronary artery disease and is as an important tool to guide decisions regarding revascularization in a significant percentage of patients with intermediate lesions. As compared to coronary FFR, the use of FFR in peripheral artery disease (PFFR) is much less prevalent. Overall data regarding the use of the PFFR is sparse. There are limited studies that have shown the correlation of PFFR with non-invasive testing including ankle-brachial index (ABI) and Doppler Imaging. Unlike coronary FFR, the optimal pharmaceutical agents and doses to induce maximal hyperemia in the peripheral vascular bed are also not well established. Moreover, there are no established standardized procedural protocols for measuring PFFR. Various studies have employed varying techniques, hyperemic agents and doses. The aim of this literature review is to summarize the current evidence on PFFR, the correlation with noninvasive studies used in PAD and to increase awareness of the potential role of the PFFR in peripheral interventions.

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Ability of Fractional Flow Reserve to Predict Restenosis After Superficial Femoral Artery Stenting

Abstract: Poststenting mean FFR is useful for predicting restenosis in SFA disease.

Cited by 12 publications

References 34 publications

Comparative Outcomes After Percutaneous Coronary Intervention Among Black and White Patients Treated at US Veterans Affairs Hospitals

Comparative Outcomes After Percutaneous Coronary Intervention Among Black and White Patients Treated at US Veterans Affairs Hospitals

Pressure- and Velocity-Based Physiological Assessment of Stenotic Lesions at Hyperemia in Superficial Femoral Artery Disease: Importance of Hyperemic Stenosis Resistance

The Use of Fractional Flow Reserve for Physiological Assessment of Indeterminate Lesions in Peripheral Artery Disease

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