Repeat FFR to LAD following PCI to LMS/LAD

↳ This is a section part of Moment: FFR guided treatment of significant bifurcation lesions using Acist Navvus micro catheter

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Summary

Following PCI to the left main stem and the proximal left anterior descending artery the operators remeasure FFR.  This demonstrates that the lesions in the mid LAD are still positive and in need of further PCI.  The operators proceed to deploy a further stent to improve the physiology and reduce the chance of the patient having angina symptoms. 

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Target Audience

  • Interventional cardiologists
  • Interventional cardiology fellows
  • Cardiologists taking care of patients with coronary artery disease
  • Catheterisation laboratory nursing and technical staff and healthcare professionals
  • Windecker S, Kolh P, Alfonso F, et al. 2014 ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2014;35:2541–2619.
  • Pijls NH, Tanaka N, Fearon WF. Functional assessment of coronary stenosis: can we live without it? Eur. Heart J. 2013;34:1335-1344.
  • Diletti R, Van Mieghem NM, Valgimigli M, et al. Rapid exchange ultra-thin microcatheter using fibre-optic sensing technology for measurement of intracoronary fractional flow reserve. EuroIntervention. 2015;11:428-432.

Learning Objectives

This case is to inform and educate interventional cardiologists on:

  • Strategy selection to approach significant true bifurcation lesions
  • Implementation of FFR assessment in bifurcation lesions
  • Implementation of FFR in side-branch assessment after provisional stenting
  • Use of microcatheter based FFR technology

Other Components in this Moment

Overview
Understanding the basics of FFR in decision making
Introduction to the Navvus pressure micro catheter
Measurement of FFR in heavily disease side branch
PCI to circumflex artery after positive FFR measurement
FFR measurement in the LAD and troubleshooting
PCI to left anterior descending artery and left main stem
Repeat FFR to LAD following PCI to LMS/LAD
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