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- W2774898178 abstract "Fractional flow reserve (FFR) is a widely used invasive index of coronary artery stenosis. FFR is not influenced by haemodynamic parameters (such as blood pressure and pulse rate) or by the vessel studied. However, true FFR value may be influenced by the presence of major collateral vessels. In this article we describe a case demonstrating this observation and discuss a potential physiological mechanism to account for this finding. © 2007 Elsevier Ireland Ltd. All rights reserved. A 77 year old man with a short history of stable exertional angina (CCS 2) underwent cardiac catheterisation. His risk factors for vascular disease included hypertension and type II diabetes mellitus. He had no other past medical history. Diagnostic angiography demonstrated well-preserved left ventricular (LV) systolic function (ejection fraction 65%) and significant three vessel coronary artery disease. The left anterior descending (LAD) and left circumflex (LCx) arteries both had moderate midvessel stenosis and the right coronary (RC) artery had a proximal functional occlusion. The distal RC artery vascular bed was perfused via well-established collaterals from the distal LAD artery. The management strategy adopted was to initially attempt percutaneous des-occlusion of the proximal RC artery. If successful the patient would in turn undergo fractional flow reserve-guided (FFR-guided) percutaneous intervention (PCI) to the LCx and LAD arteries. Coronary artery bypass graft (CABG) surgery would be adopted in the event that PCI to the proximal RC artery was not successful. FFR was measured as partofthediagnosticprocedureandwas0.75inthedistalLAD (Fig.1, Panel A)and 0.72inthe distalLCx artery (FFR ≥0.80" @default.
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- W2774898178 date "2009-01-01" @default.
- W2774898178 modified "2023-09-24" @default.
- W2774898178 title "Letter to the Editor Fractional flow reserve — The influence of the collateral circulation" @default.
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