Application Of Intravascular Ultrasound And Fractional Flow Reserve On Treatment Of Coronary Intermediate Lesion

Objectives To compare the clinical prognosis of fractional flow reserve(FFR)-guided versus intravascular ultrasound(IVUS)-guided percutaneous coronary intervention(PCI) for intermediate coronary lesions.Methods 94 patients with intermediate coronary artery lesions(stenosis of 50%- 70%) confirmed by coronary angiography were divided into 2 groups to undergo PCI for a minimal lumen cross sectional area(MLA)<4 mm2(IVUS group, 43 patients) or a FFR<0.75(FFR group, 51 lesions).Patients with a MLA?4mm2 or a FFR?0.75 directly received pharmacotherapeutics. All the patients received optimize drug treatment. We collected the adverse cardiac events including readmission, myocardial infarction, ischemia-driven target vessel revascularization and death at 6 months after the procedure, and compared the incidence of them between the 2 groups.Results 96 patients entered the study. One patient did against the suggestion from doctors and another patient died of pancreatic carcinoma. Both of the two patients did not meet the criteria. Finally, 94 patients were brought into statistical analysis, with 64 males and 30 females. 1 Both groups were well balanced with no significant differences on baseline clinical characteristics. 2 Angiographic and procedural characteristics were revealed with no significant differences between two groups. 3 The rate of patients undergoing revascularization was significantly greater in the IVUS group as compared to the FFR group(74.4% in the IVUS group and 41.2% in the FFR group; P<0.01). 4 At six-month follow-up no significant differences were observed in the composite endpoint including readmission, myocardial infarction, ischemia-driven target vessel revascularization and death either in overall groups(7.8% in the FFR group and 13.95% in the IVUS group; P =0.47) or in those with deferred intervention(6.67% in the FFR group and 9.09% in the IVUS group; P=0.08).Conclusions For intermediate coronary artery diseases, the IVUS-guided PCI strategy had the same clinical prognosis with the FFR-guided PCI strategy. More people received stent implantation in the IVUS group than that in the FFR group.