首页> 美国卫生研究院文献>Annals of Vascular Diseases >Pressure- and Velocity-Based Physiological Assessment of Stenotic Lesions at Hyperemia in Superficial Femoral Artery Disease: Importance of Hyperemic Stenosis Resistance
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Pressure- and Velocity-Based Physiological Assessment of Stenotic Lesions at Hyperemia in Superficial Femoral Artery Disease: Importance of Hyperemic Stenosis Resistance

机译:浅层股动脉疾病充血时基于压力和速度的狭窄病变的生理评估:耐高狭窄性的重要性

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摘要

>Background: In superficial femoral artery (SFA) stenosis, stenosis resistance may increase, but the relationship between stenosis resistance and stenotic severity remains to be seen. This study aimed to investigate the physiological response, through a hyperemic condition, and the pathophysiological significance of Doppler flow and stenosis resistance in SFA.>Methods: Twenty-four limbs with focal stenosis of the SFA were analyzed. We assessed the fractional flow reserve (FFR), hyperemic stenosis resistance (h-SR), and vascular flow reserve (VFR) of the SFA with a pressure/Doppler flow sensor-tipped combination guidewire before and after endovascular therapy (EVT).>Results: FFR, h-SR, and VFR changed significantly after EVT. h-SR was more strongly correlated with % area stenosis, measured by intravascular ultrasound than FFR (FFR: r=−0.716, h-SR: r=0.741, p<0.0001, respectively). However, VFR was not associated with % area stenosis. A receiver operating characteristic curve showed cut-offs h-SR >0.36 mmHg·sec/cm, and FFR <0.88 predicted >75% area stenosis with area under curves of 0.883 and 0.828, respectively.>Conclusion: h-SR can indicate stenotic severity in an SFA focal lesion more prominently than FFR and may be a new physiological index to determine indication for EVT. VFR was not feasible for assessment in SFA focal stenosis.
机译:>背景:在股浅动脉(SFA)狭窄中,狭窄阻力可能增加,但是狭窄阻力与狭窄严重程度之间的关系尚待观察。本研究旨在通过充血条件调查SFA的生理反应以及多普勒血流和狭窄抵抗的病理生理意义。>方法:分析了24例SFA局灶性狭窄的肢体。我们在血管内治疗(EVT)前后使用压力/多普勒血流传感器组合导丝评估了SFA的分数血流储备量(FFR),充血性狭窄阻力(h-SR)和血管血流储备量(VFR)。 strong>结果:EVT后,FFR,h-SR和VFR发生了显着变化。与FFR相比,通过血管内超声测得的h-SR与%狭窄率更紧密相关(FFR:r = -0.716,h-SR:r = 0.741,p <0.0001)。但是,VFR与狭窄面积百分比无关。接收器的工作特性曲线显示截止点h-SR> 0.36 mmHg·sec / cm,FFR <0.88预测的狭窄率> 75%,面积分别为0.883和0.828。>结论: h-SR可以比SFR更明显地表明SFA局灶性病变的狭窄程度,并且可能是确定EVT适应症的新生理指标。在SFA局灶性狭窄中评估VFR是不可行的。

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