Non-invasive procedural planning using computed tomography-derived fractional flow reserve
© 2020 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC..
OBJECTIVES: This study aimed to investigate the performance of computed tomography derived fractional flow reserve based interactive planner (FFRCT planner) to predict the physiological benefits of percutaneous coronary intervention (PCI) as defined by invasive post-PCI FFR.
BACKGROUND: Advances in FFRCT technology have enabled the simulation of hyperemic pressure changes after virtual removal of stenoses.
METHODS: In 56 patients (63 vessels) invasive FFR measurements before and after PCI were obtained and FFRCT was calculated using pre-PCI coronary CT angiography. Subsequently, FFRCT and invasive coronary angiography models were aligned allowing virtual removal of coronary stenoses on pre-PCI FFRCT models in the same locations as PCI was performed. Relationships between invasive FFR and FFRCT , between post-PCI FFR and FFRCT planner, and between delta FFR and delta FFRCT were evaluated.
RESULTS: Pre PCI, invasive FFR was 0.65 ± 0.12 and FFRCT was 0.64 ± 0.13 (p = .34) with a mean difference of 0.015 (95% CI: -0.23-0.26). Post-PCI invasive FFR was 0.89 ± 0.07 and FFRCT planner was 0.85 ± 0.07 (p < .001) with a mean difference of 0.040 (95% CI: -0.10-0.18). Delta invasive FFR and delta FFRCT were 0.23 ± 0.12 and 0.21 ± 0.12 (p = .09) with a mean difference of 0.025 (95% CI: -0.20-0.25). Significant correlations were found between pre-PCI FFR and FFRCT (r = 0.53, p < .001), between post-PCI FFR and FFRCT planner (r = 0.41, p = .001), and between delta FFR and delta FFRCT (r = 0.57, p < .001).
CONCLUSIONS: The non-invasive FFRCT planner tool demonstrated significant albeit modest agreement with post-PCI FFR and change in FFR values after PCI. The FFRCT planner tool may hold promise for PCI procedural planning; however, improvement in technology is warranted before clinical application.
| Errataetall: |
CommentIn: Catheter Cardiovasc Interv. 2021 Mar;97(4):623-624. - PMID 33721411 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:97 |
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| Enthalten in: |
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions - 97(2021), 4 vom: 15. März, Seite 614-622 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Bom, Michiel J [VerfasserIn] |
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| Links: |
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| Themen: |
Computed tomography derived fractional flow reserve |
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| Anmerkungen: |
Date Completed 24.09.2021 Date Revised 24.09.2021 published: Print-Electronic CommentIn: Catheter Cardiovasc Interv. 2021 Mar;97(4):623-624. - PMID 33721411 Citation Status MEDLINE |
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| doi: |
10.1002/ccd.29210 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM314183841 |
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| 245 | 1 | 0 | |a Non-invasive procedural planning using computed tomography-derived fractional flow reserve |
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| 500 | |a Date Completed 24.09.2021 | ||
| 500 | |a Date Revised 24.09.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Catheter Cardiovasc Interv. 2021 Mar;97(4):623-624. - PMID 33721411 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. | ||
| 520 | |a OBJECTIVES: This study aimed to investigate the performance of computed tomography derived fractional flow reserve based interactive planner (FFRCT planner) to predict the physiological benefits of percutaneous coronary intervention (PCI) as defined by invasive post-PCI FFR | ||
| 520 | |a BACKGROUND: Advances in FFRCT technology have enabled the simulation of hyperemic pressure changes after virtual removal of stenoses | ||
| 520 | |a METHODS: In 56 patients (63 vessels) invasive FFR measurements before and after PCI were obtained and FFRCT was calculated using pre-PCI coronary CT angiography. Subsequently, FFRCT and invasive coronary angiography models were aligned allowing virtual removal of coronary stenoses on pre-PCI FFRCT models in the same locations as PCI was performed. Relationships between invasive FFR and FFRCT , between post-PCI FFR and FFRCT planner, and between delta FFR and delta FFRCT were evaluated | ||
| 520 | |a RESULTS: Pre PCI, invasive FFR was 0.65 ± 0.12 and FFRCT was 0.64 ± 0.13 (p = .34) with a mean difference of 0.015 (95% CI: -0.23-0.26). Post-PCI invasive FFR was 0.89 ± 0.07 and FFRCT planner was 0.85 ± 0.07 (p < .001) with a mean difference of 0.040 (95% CI: -0.10-0.18). Delta invasive FFR and delta FFRCT were 0.23 ± 0.12 and 0.21 ± 0.12 (p = .09) with a mean difference of 0.025 (95% CI: -0.20-0.25). Significant correlations were found between pre-PCI FFR and FFRCT (r = 0.53, p < .001), between post-PCI FFR and FFRCT planner (r = 0.41, p = .001), and between delta FFR and delta FFRCT (r = 0.57, p < .001) | ||
| 520 | |a CONCLUSIONS: The non-invasive FFRCT planner tool demonstrated significant albeit modest agreement with post-PCI FFR and change in FFR values after PCI. The FFRCT planner tool may hold promise for PCI procedural planning; however, improvement in technology is warranted before clinical application | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a computed tomography derived fractional flow reserve | |
| 650 | 4 | |a coronary artery disease | |
| 650 | 4 | |a coronary computed tomography angiography | |
| 650 | 4 | |a fractional flow reserve | |
| 650 | 4 | |a percutaneous coronary intervention | |
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| 700 | 1 | |a Driessen, Roel S |e verfasserin |4 aut | |
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| 700 | 1 | |a Knaapen, Paul |e verfasserin |4 aut | |
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