A feasibility study of fractional flow reserve assessment for carotid artery stenosis interventional therapy / 中国脑血管病杂志

ABSTRACT

Objective This study aimed to evaluate the feasibility and safety of interventional therapy for carotid atherosclerotic stenosis using fractional flow reserve (FFR). Methods All 30 consecutive patients with symptomatic severe carotid artery stenosis (lumen stenosis > 70%) and stent implantation were retrospectively recruited. Among them, 25 patients were with cerebral infarction and 5 patients with transient ischemic attack. The blood flow of carotid atherosclerotic stenosis was measured by pressure wire. The stenosis rate,FFR (distal/proximal pressure ratio) and translesional pressure gradient (proximal pressure-distal pressure) were measured before and after intervention. Correlation between stenosis rate and FFR or translesional pressure gradient was analyzed by the Pearson correlation test. Results All 30 patients had pressure wire successfully pass the stenosis, and FFR and translesional pressure gradients were measured. Before intervention, the mean stenosis rate, FFR and translesional pressure gradients were (84 ± 6) %,0. 67 ±0. 15 and (32 ± 7) mmHg. Corresponding post-intervention measurements were (30 ± 10)%,0. 82 ± 0. 11 and (18 ± 9) mmHg respectively. The post-intervention vascular stenosis rate and translesional pressure gradient were significantly lower than those before intervention with statistically significant differences (all P <0. 01). Before intervention,vascular stenosis rate was significantly correlated with FFR and translesional pressure gradient (r was - 0 . 8 6 and 0.96, respectively, all P < 0. 01). No intracerebral hemorrhage and vascular dissection occurred by vascular puncture rupture in patients during FFR and translesional pressure gradient measurement by pressure wire. Conclusion Application of FFR is feasible and safe to evaluate the interventional treatment of carotid atherosclerosis stenosis,but more studies are needed for further verification.