Ultreon 3.0 and physiological coronary assessment: initial single-center Polish experience

Area of Science:

• Cardiovascular Imaging
• Interventional Cardiology
• Medical Device Technology

Background:

• Optical coherence tomography-derived fractional flow reserve (FFR-OCT) offers combined anatomical and functional assessment of coronary lesions.
• FFR-OCT analysis may be influenced by accurate lumen delineation and side-branch recognition.

Purpose of the Study:

• To evaluate the agreement between operator-reviewed FFR-OCT and wire-based fractional flow reserve (FFR) in clinical practice.
• To assess the impact of manual segmentation correction on FFR-OCT results.

Main Methods:

• 19 vessels from 14 patients undergoing wire-based FFR and OCT-guided PCI were analyzed.
• Automated FFR-OCT values were manually corrected for lumen and side-branch segmentation.
• Comparison involved Pearson's correlation, Bland-Altman analysis, and ischemia classification concordance.

Main Results:

• Operator review significantly improved automated FFR-OCT values (0.68 to 0.75, p=0.016).
• Operator-reviewed FFR-OCT (0.76) showed moderate correlation with wire-based FFR (0.79, r=0.614, p=0.005).
• Ischemia classification concordance was 78.9%, with 4 discordant vessels.

Conclusions:

• Manual segmentation review substantially alters FFR-OCT results.
• While FFR-OCT shows association with wire-based FFR, agreement near the 0.80 threshold is imperfect.
• Further prospective studies are needed to validate FFR-OCT's role in PCI planning.