Image in cardiology

Co-registration of fractional flow reserve and optical coherence tomography with the use of a three-dimensional angiographic roadmap: an opportunity for optimisation of complex percutaneous coronary interventions

EuroIntervention 2013;9:889. DOI: 10.4244/EIJV9I7A146

Stylianos Pyxaras
Stylianos A. Pyxaras1, MD; Shengxian Tu2, PhD; Emanuele Barbato1, MD, PhD; Eric Wyffels1, MD; Johan H.C. Reiber2, PhD; William Wijns1*, MD, PhD
1. Cardiovascular Center, OLV Clinic, Aalst, Belgium; 2. Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
Angiography of a 63-year-old male patient with unstable angina revealed a tight stenosis in the mid right coronary artery, proximal to a formerly implanted drug-eluting stent (DES). A motorised pullback of the pressure wire at 1 mm/sec during IV adenosine (140 μg/kg/min) permitted co-registration of the pressure-derived fractional flow reserve (FFR) signal along the angiographic roadmap, and the precise length (12 mm) of the segment where the pressure “jump” was derived. Additional OCT co-registration was performed revealing extensive spiral dissection at the proximal edge of the stent, extending for 23 mm proximally, and not detectable by angiography on any view (Figure 1, ...

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