The role of non-invasive wireless functional flow reserve physiology assessment of the collaterals-donor vessel in a complex CTO intervention; first case report

Mohammed Salih , Ghadi Moubarak , Dinesh Apala , Karim Al-Azizi
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Abstract

We present an interesting case of a 73 years-old male who was referred for mid-right coronary artery (RCA) chronic total occlusion (CTO) intervention given continuous angina symptoms with coronary angiogram revealing mid-RCA CTO with a left to right collaterals from LAD and concomitant moderate stenosis in the mid-LAD. Hemodynamic assessment of this lesion pre-PCI using non-invasive angiogram-based, wireless FFR was performed. Following successful CTO revascularization, a substantial immediate improvement in non-invasive angio-FFR assessment was observed with wireless angio-based FF measurement of 0.96 (normal ≥0.80) compared to the pre-intervention value of 0.86. This suggests that angiography-based wireless FFR may be a valuable tool for assessing the hemodynamic significance of donor artery stenosis in CTO cases, potentially offering a less invasive and more accessible alternative to traditional methods.

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无创无线功能性血流储备生理评估在复杂 CTO 干预术中的作用;首例报告
我们介绍了一例有趣的病例,患者是一名 73 岁的男性,因持续心绞痛症状而被转诊到右冠状动脉(RCA)中段慢性全闭塞(CTO)介入治疗,冠状动脉造影显示 RCA 中段 CTO,并伴有来自 LAD 的从左到右的袢,以及 LAD 中段的中度狭窄。使用基于血管造影的无创无线 FFR 对该病变进行了冠状动脉造影前血液动力学评估。成功进行 CTO 血管再通后,无创血管-FFR 评估结果立即得到大幅改善,基于无线血管造影的 FF 测量值为 0.96(正常值≥0.80),而干预前为 0.86。这表明,基于血管造影的无线 FFR 可能是评估 CTO 病例中供体动脉狭窄的血流动力学意义的重要工具,有可能成为传统方法之外的一种创伤更小、更方便的替代方法。
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