8 The influence of collateral regression post coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI) on donor vessel coronary pressure-derived measurements. (27th November 2017)

• Record Type: Journal Article
• Authors: Mohdnazri, SR; Al-Janabi, F; Karamasis, G; Hampton-Till, J; Al-Lamee, R; Dungu, J; Gedela, S; Tang, KH; Kelly, PA; Davies, JE; Davies, R; Keeble, TR
• Is Part Of: Heart. Volume 103(2017)Supplement 7
• Page Start: A4
• Page End: A4
• Publication Date: 2017-11-27
• Subjects: Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2017-BCIS.8
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Background: There is strong evidence of FFR-guided treatment in multi-vessel disease. The presence of a concomitant CTO may influence the FFR measurement in donor vessel. We sought to investigate the influence of collateral regression after successful CTO recanalisation on donor vessel pressure-derived indices. Methods: 28 out of 34 consecutive patients underwent successful PCI to RCA CTOs and completed the follow up study (at 3 months post CTO-PCI). Resting Pd/Pa, iFR and FFR were measured pre and post successful CTO PCI and at follow-up in donor vessels. Results: The mean resting Pd/Pa, iFR and FFR pre and post-RCA CTO PCI and at follow-up procedures in major donor vessel were (0.893, 0.862, 0.764), (0.907, 0.886, 0.753) and (0.918, 0.901, 0.787) respectively. The mean resting Pd/Pa, iFR and FFR pre and post-RCA CTO PCI and at follow-up procedures in minor donor vessel were (0.979, 0.966, 0.890), (0.983, 0.979, 0.880) and (0.981, 0.974, 0.898) respectively. Changes in pressure-derived indices are summarised in table 1. Conclusion: Successful recanalisation of a RCA CTO results in a significant increase in coronary pressure-derived indices of the major donor vessel at follow-up associated with a regression of collateral function. The expected change and the optimal timing to perform PCI in donor vessel should be considered when planning multi-vessel revascularisation in this setting.