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Utility of myocardial fractional flow reserve for prediction of restenosis following sirolimus-eluting stent implantation

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Abstract

Drug-eluting stents reduce restenosis due to neointimal growth suppression. Considering long-term outcomes, it is both difficult and important to predict drug-eluting stent restenosis. Thus, this study was designed to examine the utility of myocardial fractional flow reserve (FFR) as a predictor of sirolimus-eluting stent (SES) restenosis. Thirty-three patients (35 lesions) were enrolled. Upon completion of SES implantation, FFR was obtained under hyperemia. At 8 months of follow-up, coronary angiography revealed that five lesions had restenosis. Percent diameter stenosis (restenosis 68.7 ± 12.8% vs. non-restenosis 68.7 ± 12.4%, p = 0.78) and lesion length (restenosis 15.8 ± 9.4 mm vs. non-restenosis 14.4 ± 9.2 mm, p = 0.60) were similar. At post-intervention, percent diameter stenosis (restenosis 16.4 ± 6.1% vs. non-restenosis 14.0 ± 7.4%, p = 0.48) and minimum stent area (restenosis 6.01 ± 1.08 mm2 vs. non-restenosis 6.27 ± 1.85 mm2, p = 0.92) were also equivalent. However, proximal edge lumen area was smaller (restenosis 4.24 ± 1.40 mm2 vs. non-restenosis 7.73 ± 2.64 mm2, p = 0.004) and FFR was lower in the restenosis group (restenosis 0.81 ± 0.12 vs. non-restenosis 0.92 ± 0.06, p = 0.029). SES patients with restenosis had a lower FFR post stent deployment, suggesting the decreased FFR may be a useful predictor for SES restenosis.

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Acknowledgments

We thank Heidi N. Bonneau, RN, MS, CCA (Highlands Consulting Inc.), for her editorial assistance.

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Authors and Affiliations

  1. Department of Cardiology, Higashisumiyoshi Morimoto Hospital, Osaka, Japan

    Hideshi Ishii

  2. Department of Internal Medicine and Cardiology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan

    Toru Kataoka, Takara Tsumori, Ryo Matsumoto, Nobuyuki Shirai, Takao Hasegawa, Shinji Nakata, Shoichi Ehara, Takashi Muro & Minoru Yoshiyama

  3. Department of Cardiology, Moriguchi Ikuno Memorial Hospital, Moriguchi, Japan

    Yoshiki Kobayashi

  4. Division of Cardiology, Tsukazaki Hospital, Himeji, Japan

    Hiroaki Takeshita

  5. Department of Cardiology, Ishikiriseiki Hospital, Higashiosaka, Japan

    Hiroki Nishioka

  6. Department of Cardiology, Shiroyama Hospital, Habikino, Japan

    Yoshihisa Shimada

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  1. Hideshi Ishii
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Correspondence to Toru Kataoka.

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Ishii, H., Kataoka, T., Kobayashi, Y. et al. Utility of myocardial fractional flow reserve for prediction of restenosis following sirolimus-eluting stent implantation. Heart Vessels 26, 572–581 (2011). https://doi.org/10.1007/s00380-010-0105-1

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  • DOI: https://doi.org/10.1007/s00380-010-0105-1

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