Prospective evaluation of the impact of side-holes and guide-catheter disengagement from the coronary ostium on fractional flow reserve measurements

Krishna S. Patel, Georgios E. Christakopoulos, Aris Karatasakis, Barbara Anna Danek, Phuong Khanh J Nguyen-Trong, Suwetha Amsavelu, Jeffrey F. Stetler, Bavana V. Rangan, Michele Roesle, Shuaib Abdullah, Tayo Addo, Subhash Banerjee, Emmanouil S. Brilakis

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

BACKGROUND: We prospectively examined the impact of side-holes and guide-catheter disengagement on fractional flow reserve (FFR) measurements. METHODS: Twenty-five patients undergoing clinically indicated FFR measurement for intermediate coronary artery stenosis were enrolled. Four FFR measurements were made in random order during intravenous adenosine infusion with: (a) an engaged side-hole guide catheter; (b) a disengaged side-hole guide catheter; (c) an engaged non-side-hole guide catheter; and (d) disengaged non-side-hole guide catheter. RESULTS: Mean patient age was 65 ± 9 years and 100% were men. The mean distal poststenotic pressure/proximal aortic pressure (Pd/Pa) at baseline was 0.93 ± 0.05 mm Hg. Using intravenous adenosine infusion, the mean FFR measured with engaged vs disengaged non-side-hole guide catheters was 0.87 ± 0.09 vs 0.83 ± 0.10, respectively (mean difference, 0.039 ± 0.04; P<.001). The mean FFR with engaged vs disengaged side-hole guide catheters was 0.85 ± 0.10 vs 0.83 ± 0.10 (mean difference, 0.020 ± 0.02; P<.001). The mean difference in FFR measurements was 0.024 ± 0.03 (P<.001) among engaged guide catheters and 0.005 ± 0.03 (P≤.47) among disengaged guide catheters. CONCLUSIONS: When FFR measurements are performed with engaged guide catheters, side-hole catheters provide lower measurements. When FFR measurements are obtained with disengaged guide catheters, they are even lower and similar between guide catheter types.

Original languageEnglish (US)
Pages (from-to)306-310
Number of pages5
JournalJournal of Invasive Cardiology
Volume28
Issue number8
StatePublished - Aug 1 2016

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Patel, K. S., Christakopoulos, G. E., Karatasakis, A., Danek, B. A., Nguyen-Trong, P. K. J., Amsavelu, S., Stetler, J. F., Rangan, B. V., Roesle, M., Abdullah, S., Addo, T., Banerjee, S., & Brilakis, E. S. (2016). Prospective evaluation of the impact of side-holes and guide-catheter disengagement from the coronary ostium on fractional flow reserve measurements. Journal of Invasive Cardiology, 28(8), 306-310.