Post-occlusional hyperemia for fractional flow reserve assessment and pull-back curve analysis

The objective of this study was to determine the clinical usefulness of post-occlusional hyperemia. FFRs measured using post-occlusional hyperemia caused by 30 (FFRoccl30) and 60  s (FFRoccl60) of balloon occlusion after PCI were compared in 60 lesions from 60 patients. The duration of hyperemia was also measured. There was a strong correlation between FFRoccl30 and FFRoccl60 (r = 0.969,p <  0.01). The duration of hyperemia was significantly longer with FFRoccl60 than with FFRoccl30 (68  ± 23 vs. 37 ± 15 s,p <  0.01). The time required for pullback curve analysis was around 45 s. However, in 7 (12%) cases, the duration of hyperemia with FFRoccl60 was<  45 s, which was not enough for pull-back curve analysis. To predict the duration of hyperemia with FFRoccl60≥ 45 s, the receiver operating characteristic curve analysis revealed a cut-off value of 25 s of hyperemia with FFRoccl30. FFRoccl30 is sufficient for diagnostic purposes. FFRoccl60 is suitable for pull-back curve analysis in select cases based on predictions made using the duration of hyperemia with FFRoccl30.
Source: Cardiovascular Intervention and Therapeutics - Category: Cardiology Source Type: research