Details

Autor(en) / Beteiligte

• Jensen, Lisette Okkels
• Thayssen, Per
• Lassen, Jens Flensted
• Hansen, Henrik Steen
• Kelbæk, Henning
• Junker, Anders
• Pedersen, Knud Erik
• Hansen, Knud Nørregaard
• Krusell, Lars Romer
• Botker, Hans Erik
• Thuesen, Leif

Titel

Recruitable collateral blood flow index predicts coronary instent restenosis after percutaneous coronary intervention

Ist Teil von

• European heart journal, 2007-08, Vol.28 (15), p.1820-1826

Ort / Verlag

Oxford: Oxford University Press

Erscheinungsjahr

2007

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Aims Collateral flow may influence long-term results after percutaneous coronary intervention (PCI) because of haemodynamic forces compete with the antegrade flow through the dilated lesion. The aim of the study was to assess the influence of recruitable collateral blood flow on restenosis in patients undergoing PCI with bare metal stents and using optimal antithrombotic treatment. Methods and results In 95 patients, 95 de novo lesions were treated with PCI and a bare metal stent. Fractional flow reserve (FFR) at maximum hyperaemia induced by intravenous adenosine was determined. The pressure-derived collateral flow index (CFI) was determined as (Pw−Pcvp)/(Pa−Pcvp), where Pw represents coronary wedge pressure, Pcvp central venous pressure, and Pa mean aortic blood pressure. Both were measured during transient coronary occlusion by a balloon inflation of 30 s. Pre-interventional FFR (0.65 ± 0.20) correlated inversely with the CFI (0.18 ± 0.11), r =− 0.356, P < 0.001. After 9 months, binary angiographic restenosis (≥50% diameter stenosis) was seen in 29.1%. Compared to patients with poorly developed collaterals (CFI < 0.25), patients with well-developed collaterals (CFI ≥ 0.25) had a lower pre-interventional FFR (0.50 ± 0.14 vs. 0.72 ± 0.18, P < 0.001), a higher CFI (0.33 ± 0.08 vs. 0.13 ± 0.07, P < 0.001), and a higher binary restenosis rate (54.2% vs. 19.4, P = 0.003). CFI*100 was an independent predictor of restenosis after 9 months (odds ratio 1.07, 95% CI 1.02–1.12, P = 0.016). Conclusion Recruitable collateral blood flow measured during balloon inflation predicts angiographic instent restenosis in PCI patients treated with bare metal stents.