Comparison of myocardial fractional flow reserve and intravascular ultrasound for the assessment of slotted-tube stents

Intravascular ultrasound (IVUS) and myocardial fractional flow reserve (FFR ) have been reported to provide similar results for assessment of coil sten t deployment Their relative value in slotted-tube stents has not been inves tigated. Fourteen patients subjected to coronary angioplasty and IVUS-guide d elective stenting with a slotted-tube stent underwent IVUS assessment and FFR measurement following stent implantation at inflation pressures of 12 and 18 atm. FFR values (mean +/- SD) preangioplasty, postangioplasty, and p oststenting at 12 atm and 18 atm, were 0.58 +/- 0.07, 0.83 +/- 0.05, 0.94 /- 0.02, and 0.94 +/- 0.02, respectively. After inflation at 12 atm, the ar ea under the receiver operating characteristic (ROC) curve for the concorda nce of IVUS and FFR measurements was 0.89 (P = 0.02), Six patients had eith er an abnormal IVUS (n = 2) or FFR < 0.94 (n = 1) or both abnormal IVUS and FFR < 0.94 (n = 3) after the first inflation and had a second inflation at 18 atm. The area under the ROC curve for the concordance between IVUS and FFR final measurements was 0.855 (P = 0.10). Perfect concordance between IV US and FFR was seen only for FFR values less than 0.91 or larger than 0.94. Overall, IVUS and FFR have substantial concordance with respect to slotted -tube stent deployment. However, FFR values between 0.91 and 0.94 after inf lation are difficult to interpret. (C) 2001 Wiley-Liss, Inc.