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Osama Sanad
Hisham Abo Elanin
Hazim Khamis
Wail Tawfik
Mohamed A. Tabl*
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Osama Sanad
Hisham Abo Elanin
Hazim Khamis
Wail Tawfik
Mohamed A. Tabl*
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International Journal of Cardiology and Cardiovascular Research

Assessment of Intermediate Coronary Artery Lesion with Fractional Flow Reserve (FFR) versus Intravascular Ultrasound (IVUS)

Mohamed A. Tabl1*, Osama Sanad1, Hisham Abo Elanin1, Hazim Khamis2, Wail Tawfik1   

1*Department of Cardiology, Benha Faculty of Medicine, Benha University, Benha, Egypt.

2Wadi El Nile Hospital , Cairo , Egypt.

Accepted December 03, 2015.

Citation: Tabl MA, Sanad O, Elanin HA, Khamis H, Tawfik W (2016). Assessment of Intermediate Coronary Artery Lesion with Fractional Flow Reserve (FFR) versus Intravascular Ultrasound (IVUS). International Journal of Cardiology and Cardiovascular Research, 3(1): 012-018.

 

Copyright: © 2016 Tabl et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are cited.

Abstract

Fraction flow reserve (FFR) is considered the gold standard for assessing intermediate coronary lesions. Retrospective data analyses showed variable relationship between intravascular ultrasound (IVUS) parameters and FFR results. This study aimed to determine the optimal minimum lumen area (MLA) by IVUS that correlates with FFR and to assess the correlation between two modalities in assessing intermediate coronary lesions. Methods: Fifty eight intermediate coronary lesions mainly located in proximal and mid segments of large main coronary vessels with RVD (3-4mm) were analyzed using both IVUS and FFR to assess the significance of coronary stenting and to determine the optimal IVUS-MLA that correlates with FFR value < 0.8. Results: IVUS-MLA ranged from 2.5 to 4.2 mm2 had a highly significant positive correlation with FFR value < 0.8 (p < 0.0001). Using the ROC curve analysis, IVUS-MLA < 3.9 mm2 (84.2% sensitivity, 80% specificity, area under curve (AUC) = 0.68) was the best threshold value for identifying FFR <0.8 in coronary vessels with RVD (3-4 mm). Conclusion: Anatomic measurements of intermediate coronary lesions obtained by IVUS show a good correlation with FFR measurements. IVUS-MLA ≤ 3.9 mm² was the best cut off value for identifying FFR < 0.8 in coronary vessels with RVD (3-4mm). Different MLA cutoffs should be used for different vessel diameters.

Key words: Fractional Flow Reserve, Intravascular Ultrasonography, Intermediate stenosis.

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