Evaluation of the outcomes of coronary physiologyguided stenting
https://doi.org/10.15829/1728-8800-2025-4436
EDN: WPBQDK
Abstract
Aim. To assess the achievement of optimal outcome criteria based on fractional flow reserve (FFR) data during coronary physiology-guided percutaneous coronary intervention (PCI) with in patients with stable coronary artery disease (CAD).
Material and methods. A total of 150 patients with stable CAD and borderline coronary stenosis were initially recruited. After applying the exclusion criteria and FFR assessment, 55 patients were included in the study. They underwent angiography-guided stenting with FFR reassessment after the intervention. In residual ischemia, additional procedures were performed to optimize the outcome with intracoronary physiology reassessment.
Results. When evaluating outcomes using the physiological index, we found that stenting did not eliminate ischemia in 15 cases (27,3%), and optimal FFR values were achieved in only 12 (21,8%) patients. Optimization of PCI outcomes was required in 17 (30,9%) patients. After optimization, residual ischemia persisted in 7 (12,7%) patients, while optimal physiological index values were not achieved in 32 (58,2%) patients. Optimal FFR values were achieved in only 16 (29,1%) patients.
Conclusion. The use of intravascular physiology methods makes it possible not only to assess the significance of coronary artery stenosis but also to improve PCI outcomes.
About the Authors
A. Yu. Kolesnikov
Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation
Russian Federation
Sosnovy Boulevard, 6, Kemerovo, 650002
A. A. Arnt
Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation
Russian Federation
Sosnovy Boulevard, 6, Kemerovo, 650002
N. A. Kochergin
Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation
Russian Federation
Sosnovy Boulevard, 6, Kemerovo, 650002
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Supplementary files
What is already known about the subject?
- Optimizing the percutaneous coronary intervention (PCI) outcomes is one of the most pressing issues in modern endovascular practice.
- The conventional angiography-guided PCI does not always achieve the target outcomes.
- The use of coronary physiological indices is considered a promising solution.
What might this study add?
- Angiography-guided stenting fails to eliminate ischemia in one-third of cases, and in 50,9% of cases, it fails to achieve the optimal PCI outcome.
- The use of fractional flow reserve methods allows not only to assess the significance of coronary artery stenosis but also to improve PCI outcomes.
Review
For citations:
Kolesnikov A.Yu., Arnt A.A., Kochergin N.A. Evaluation of the outcomes of coronary physiologyguided stenting. Cardiovascular Therapy and Prevention. 2025;24(9):4436. (In Russ.) https://doi.org/10.15829/1728-8800-2025-4436. EDN: WPBQDK
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