Residual angina pectoris after percutaneous coronary intervention for acute coronary syndrome

Area of Science:

• Cardiology
• Interventional Cardiology
• Diagnostic Imaging

Background:

• Fractional flow reserve (FFR) is crucial for guiding decisions in cardiac catheterization and evaluating percutaneous coronary interventions (PCI).
• The pressure pullback curve during maximal hyperemia is effective in pinpointing coronary stenosis severity and location.
• This technique can also reveal diffuse coronary artery disease.

Purpose of the Study:

• To present a case where FFR with pressure pullback curve identified diffuse coronary disease post-PCI.
• To illustrate the utility of FFR in cases with incomplete symptom relief after intervention.

Main Methods:

• Utilized Fractional Flow Reserve (FFR) measurement.
• Performed a pressure pullback curve analysis at maximal hyperemia seven days after PCI.
• Correlated FFR findings with patient's persistent symptoms.

Main Results:

• The FFR pressure pullback curve indicated the presence of diffuse coronary artery disease.
• This finding was observed despite a prior PCI that did not fully alleviate the patient's symptoms.

Conclusions:

• FFR with pressure pullback curve is valuable for diagnosing diffuse coronary disease, even after PCI.
• Medical management was initiated based on the FFR findings of diffuse disease.