Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Fractional Flow Reserve Versus Angiography in Left Circumflex Ostial Intervention After Left Main Crossover Stenting

  • Nam, Chang-Wook (Department of Internal Medicine, Keimyung University College of Medicine) ;
  • Hur, Seung-Ho (Department of Internal Medicine, Keimyung University College of Medicine) ;
  • Koo, Bon-Kwon (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Doh, Joon-Hyung (Department of Internal Medicine, Inje University College of Medicine, Ilsan Paik Hospital) ;
  • Cho, Yun-Kyeong (Department of Internal Medicine, Keimyung University College of Medicine) ;
  • Park, Hyoung-Seob (Department of Internal Medicine, Keimyung University College of Medicine) ;
  • Yoon, Hyuck-Jun (Department of Internal Medicine, Keimyung University College of Medicine) ;
  • Kim, Hyung-Seop (Department of Internal Medicine, Keimyung University College of Medicine) ;
  • Chung, In-Sung (Department of Internal Medicine, Keimyung University College of Medicine) ;
  • Kim, Yoon-Nyun (Department of Internal Medicine, Keimyung University College of Medicine) ;
  • Fearon, William F. (Stanford University Medical Center, Cardiovascular Medicine) ;
  • Tahk, Seung-Jae (Department of Internal Medicine, Ajou University School of Medicine) ;
  • Kim, Kwon-Bae (Department of Internal Medicine, Keimyung University College of Medicine)
  • Published : 2011.06.30
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Abstract

Background and Objectives: 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. Subjects and Methods: 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. Results: The mean reference diameter of LCX was 3.1${\pm}$0.4 mm, and percent diameter stenosis after crossover stenting was 56${\pm}$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. Conclusion: There was a discrepancy between angiographic percent diameter stenosis and FFR in jailed LCX lesions after LM crossover stenting.

Keywords

References

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