The Acute Changes of Fractional Flow Reserve in DK (Double Kissing), Crush, and 1‐Stent Technique for True Bifurcation Lesions

Abstract

In the acute phase, immediately after PCI for bifurcation lesion, DK crush stenting was associated with higher FFR and lower residual diameter stenosis in the SB, as compared with the provisional 1-stent group.

Clinical applications of fractional flow reserve in bifurcation lesions

“…In a study by Lee et al ,[45] SB FFR was measured before and after kissing balloon dilatation in patients treated with the crush technique, and kissing balloon dilatation increased FFR from 0.94 ± 0.04 to 0.97 ± 0.03 ( P = 0.011). Another study reported that double kissing crush stenting was associated with higher SB FFR as compared with the provisional strategy in true bifurcation lesions (0.94 ± 0.3 in crush vs. 0.90 ± 0.08 in provisional group, P = 0.028) [46]. These results suggest that SB FFR can be helpful to assess the procedural success after SB stenting.…”

Definite stent thrombosis after drug‐eluting stent implantation in coronary bifurcation lesions: A meta‐analysis of 3,107 patients from 14 randomized trials

“…We identified 14 published RCTs (3,107 patients) that met our inclusion criteria (Figure 1), with a mean follow-up time of 25.6 months [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. A total of 1,522 patients were treated with a SS strategy, and 1,585 patients were managed with a DS approach (ITT).…”

“…However, randomized control trials (RCTs) have been too underpowered to detect differences of ST rates between SS versus DS group [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27], although there has been a trend in a reduction of ST with a SS strategy [11,13,14,16,18]. In addition, owing to variable follow-up durations across studies (6-60 months), evaluation of the true rate of late, very late or overall ST is difficult [28][29][30][31][32].…”

血流储备分数应用于冠状动脉分叉病变的研究进展

“…既往研究显示 [17] ，支架术后 FFR 所测结果是心血管事件的独立预测因子，FFR＞0.9 的患者，支架术后 心血管事件发生率明显降低。FFR 能够对复杂的分叉病变双支架植入术提供有价值的参考信息。Lee 等 [18] 对分叉病变采取 Crush 术式后，对主支和边支行对吻性球囊扩张，术前术后均行 FFR 检测，结果发现对吻 性球囊扩张可明显提升边支的 FFR 值。另一项研究表明 [19] ，对于真性分叉病变，双对吻 Crush 支架术较必 要时边支支架术能取得更好的 FFR 值。这些研究结果提示，边支支架术后的 FFR 测量有助于评估支架植入 后的效果，然而需要注意的是，较高的 FFR 值并不总是意味着复杂病变后有更好的预后，FFR 在预测边支 支架术后的远期疗效方面尚有局限性。 …”