Changes in absolute flow, myocardial resistance and FFR after chronic total occlusion percutaneous coronary intervention
Authors' conclusion
Post-CTO PCI, there is a continued augmentation in absolute coronary blood flow and reduction in microvascular resistance from baseline to follow-up at 3 months. Prior CABG and a higher baseline eGFR were predictors of a larger change in absolute coronary flow, whilst an extraplaque final wire path strategy predicted a smaller change. Lastly, the patient characteristics and comorbidities had a larger influence than procedural factors on the observed change in absolute flow.
Study context
- Population
- Patients with a chronic total occlusion (CTO) subtending viable myocardium undergoing successful CTO percutaneous coronary intervention (PCI) (hybrid algorithm)
- Participants
- 81 patients
- Exposure
- 3-month follow-up vs immediately post-CTO PCI
- Outcome
- Recovery of absolute coronary blood flow (continuous thermodilution)
- Follow-up
- 3-month follow-up
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Absolute coronary blood flow in CTO vessel increased
30%
Microvascular resistance reduced
16%
FFR increased
0.02
Observational data: associations, not effects.
Further findings
Predictors of change in absolute flow
- Prior coronary artery bypass graft (CABG) and higher estimated glomerular filtration rate (eGFR) associated with larger change in absolute flow
- Extraplaque strategy associated with smaller change in absolute flow
Original publication
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