Randomized Comparison of Fractional Flow Reserve and Instantaneous Wave Free Ratio in Serial Disease

作者：Matthew Li Kam Wa, Saad Ezad, Bhavik Modi, Ozan M. Demir, Jonathan Hinton, Howard Ellis, Kalpa De Silva, Ankur Gulati, Ranil de Silva, Peter O’Kane, Abdel Douiri, Damien Collison, Nick Curzen, Carlos Collet, Divaka Perera · 发表于：JACC: Cardiovascular Interventions · 年份：2025 · DOI：10.1016/j.jcin.2025.05.033 · 被引用次数：7 · 研究领域：Coronary Interventions and Diagnostics、Cerebrovascular and Carotid Artery Diseases、Cardiac Imaging and Diagnostics

BACKGROUND: ), but this approach is unvalidated. OBJECTIVES: (a mathematical solution incorporating interaction between lesions) for predicting post-PCI physiology in serial or diffuse disease. METHODS: Patients with a focal target lesion and either a second focal lesion or a diffusely diseased segment in the same vessel were randomized to FFR- vs iFR-guided PCI (ISRCTN18106869). FFR and iFR pullbacks were performed, with operators blinded to one modality. Following target lesion PCI, FFR and iFR were remeasured. The primary outcome was the error in predicted post-PCI physiology compared with actual values. RESULTS: . CONCLUSIONS: FFR and iFR pullback gradients overestimate the benefit of target lesion PCI and can miss residual ischemia in one-third of patients. FFR or iFR should be routinely repeated post-PCI in serial disease.