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

摘要

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 motor-ised pullback of the pressure wire at 1 mm/sec during IV adenosine (140 ug/kg/min) permitted co-registration of the pressure-derived fractional flow reserve (FFR) signal along the angi-ographic 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, Moving image 1).