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Effect of the fractional flow reserve (FFR) on the treatment of coronary bifurcation disease

Objective: This study is mainly to evaluate the effect of left anterior descending coronary artery after implantation on the first diagonal branch and guiding effect of the Fractional Flow Reserve (FFR) on the treatment of coronary bifurcation disease.

Methods: A total of 78 patients with left anterior descending coronary artery disease (LAD) were enrolled in this study. After implantation of coronary artery left anterior descending (LAD) stent, it was divided into FFR>0.80 group (58 cases) and FFR ≤ 0.80 group (20 example) according to marginal branch FFR scores. The general clinical features and hematological findings of the patients were observed and recorded, including blood, blood glucose, low density lipoprotein, renal function and uric acid.

Results: The contrast of before PCI operation LAD reference vessel diameter ((3.12 ± 0.15)(3.15 ± 0.17 mm), P=0.774), Quantitative Coronary Angiography (QCA) percent diameter stenosis ((0.85 ± 0.13%), (0.76 ± 0.14%), P=0.812), Lesion length ((19.89 ± 5.63), (21.53 ± 7.56 mm), P=0.659), FFR mean value (0.63 ± 0.12, 0.52 ± 0.23, P=0.824) with after LAD PCI angular branch reference blood vessel diameter ((2.61 ± 0.25), (2.59 ± 0.24 mm), P=0.746), QCA lesion percent diameter stenosis ((0.45 ± 0.18%), (0.54 ± 0.15%), P=0.112), minimum lumen diameter ((1.36 ± 0.520, (1.14 ± 0.49 mm), P=0.153), the differences were not of statistically significant (P>0.05); However, it has the statistically significance (P<0.01) of the differences in the angular branch FFR mean value (0.75 ± 0.14, 0.67 ± 0.13) after LAD PCI. After anterior descending stent implantation, in the diastolic branch greater than 0.80 group, there are 15.5% patients of QCA diameter stenosis greater than or equal to 70.0% is false negative; in the diastolic FFR ≤ 0.80 group, 70.0% of the patients with QCA diameter stenosis of less than 70.0% is false negative.

Conclusion: FFR can significantly reduce the complexity of bifurcation and improve the efficiency of diagnosis in the treatment of coronary artery bifurcation.

Author(s): Jie-min Chen, Jun Lan, Chang Tu, Fei Cheng, Ying Du, Ruijie Liu, Yao-tang Zhong, Ji-Yan Chen