FFR in bifurcation stenting: what have we learned?

Area of Science:

• Cardiovascular medicine
• Interventional cardiology
• Medical imaging

Background:

• Current methods for evaluating side branch lesion severity, including angiographic and flow criteria, lack validation.
• Angiographic assessment alone can be inaccurate, failing to reflect the true functional severity of stenosis, particularly in ostial lesions.

Purpose of the Study:

• To compare the functional and angiographic severity of side branch lesions.
• To evaluate the functional outcomes of jailed side branch lesions post-intervention during follow-up.

Main Methods:

• Utilizing Fractional Flow Reserve (FFR) as a validated, lesion-specific parameter for physiologic evaluation of coronary artery stenosis.
• Conducting investigations to compare functional severity with angiographic severity in side branch lesions.
• Assessing functional outcomes of jailed side branch lesions during follow-up after intervention.

Main Results:

• FFR-guided provisional side branch intervention is a feasible and effective strategy for bifurcation lesions.
• Angiographic evaluation tends to overestimate the functional severity of jailed side branch lesions throughout the provisional strategy.
• The functional status of jailed side branch lesions remains stable during follow-up after drug-eluting stent implantation.

Conclusions:

• FFR provides a more accurate assessment of coronary artery stenosis severity compared to traditional angiography.
• An FFR-guided approach is recommended for managing bifurcation lesions, optimizing intervention strategies.
• Jailed side branch lesions show stable functional status post-intervention, indicating favorable long-term outcomes.