Proper Fractional Flow Reserve Criteria for Intermediate Lesions in the Era of Drug-eluting Stent

Deferral of Angioplasty According to Fractional Flow Reserve vs. Routine Drug-eluting Stent Implantation in Intermediate Coronary Stenosis

Angiographic evaluation for intermediate lesions is not always accurate. Fractional flow reserve-guided deferral strategy for these lesions showed the same event rate as routine intervention strategy. However, proper FFR criterion for these lesions in the era of drug-eluting stent is not known. This study sought to evaluate the clinical outcomes of intermediate lesions according to FFR and compare those of FFR-guided intervention with routine drug-eluting stent implantation strategy.

Inclusion Criteria:

• Elective PCI
• Angiographically intermediate stenosis (50-75% by visual estimation) in native major coronary arteries, proximal and mid (branch, distal lesion: exclusion)
• Reference diameter > 2.5mm, lesion length < 60mm (cover by 2 stents)
• No documented evidence of ischemia by noninvasive tests

Exclusion Criteria:

• Acute ST elevation MI
• Left main disease
• Chronic renal failure (cr >2 mg/dL)
• Expected survival < 2yrs
• > 1degree AV block