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Published on: November 24, 2014
Serial quantitative flow ratio measurements of a successfully recanalized coronary chronic total occlusion
Mohamed Samy1, Abdelhakim Allali2, Sultan Alotaibi3
1Cardiology Department, Heart Center Segeberger Kliniken GmbH, Bad Segeberg, Germany; Cardiology Department, Zagazig University, Sharkia, Egypt.
Background:
Physiological assessment is useful in detecting suboptimal results after percutaneous coronary intervention (PCI). However, after angiographically successful PCI of a chronic total occlusion (CTO), coronary perfusion changes over time, which may impact physiological assessment.
Purpose:
To evaluate the functional results of CTO PCI measured by quantitative flow ratio (QFR) immediately and 6 months following the PCI.
Methods:
We retrospectively included patients with a successful CTO-PCI from a single center between 2017 and 2020. A total of 139 patients who fulfilled the QFR eligibility criteria, out of 470 CTO-PCIs, were enrolled. The QFR was measured off-line in the target vessel immediately post-index procedure and after a follow-up of 6 months.
Results:
The mean age was 67.3 ± 10 years, and 80.6% were males. 74.8% of lesions had J-CTO score ≥2, retrograde approach was used in 10.8%. The median QFR immediately after successful CTO-PCI was 0.96 IQR [0.92-0.99] which increased to 0.97 IQR [0.94-0.99] after follow-up (p=0.045). Immediately post CTO-PCI, 19.4% (n=27) of patients had QFR < 0.91, and 80.6% (n=112) had QFR ≥ 0.91. After 6 months, QFR increased significantly in patients with initial suboptimal QFR (0.87 IQR [0.85-0.88] vs 0.97 IQR [0.92-0.99], p<0.001). Patients with persistent high QFR or those with improving QFR ≥ 0.91 at follow up had lower rates of two-year target vessel failure (HR 0.22, 95% CI: 0.09-0.54, p=0.002).
Conclusion:
After CTO recanalization, QFR increased significantly at 6 months in most of the patients with low initial values. Patients with persistent high QFR or those with improving QFR ≥ 0.91 after a short-term follow up had lower rates of two-year TVF.
