Prognostic value of quantitative flow ratio measured immediately after drug‐coated balloon angioplasty for in‐stent restenosis

• Published in: Catheterization and cardiovascular interventions Vol. 97; no. S2; pp. 1048 - 1054
• Main Authors: Cai, Xiaoqing, Tian, Feng, Jing, Jing, Jin, Qinhua, Zhou, Shanshan, Yin, Weijun, Chen, Yufang, Wu, Qiang, Fu, Zhenhong, Chen, Yundai
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.05.2021; Wiley Subscription Services, Inc
• Subjects: Angiography; Angioplasty; Angioplasty, Balloon, Coronary - adverse effects; Balloon treatment; Coated Materials, Biocompatible; computational fluid dynamics algorithm; Coronary Angiography; Coronary Restenosis - diagnostic imaging; Coronary Restenosis - etiology; Coronary Restenosis - therapy; Drug-Eluting Stents; fractional flow reserve; Fractional Flow Reserve, Myocardial; Humans; Implants; Lesions; Medical imaging; Paclitaxel; Pharmaceutical Preparations; Prognosis; quantitative coronary angiography; Restenosis; stent restenosis; Stents; Treatment Outcome; quantitative coronary angiography; computational fluid dynamics algorithm; fractional flow reserve; stent restenosis
• ISSN: 1522-1946; 1522-726X
• DOI: 10.1002/ccd.29640

Objectives This study aimed to evaluate prognostic value of quantitative flow ratio (QFR) in drug‐coated balloon (DCB) angioplasty for in‐stent restenosis (ISR). Background There is a high incidence of recurrent ISR after DCB angioplasty. QFR is a novel method for fast computation of fractional flow reserve for the target vessel based on quantitative coronary angiography (QCA) and fluid dynamics algorithms. Methods Patients participating in the RESTORE ISR China randomized trial were enrolled and classified into the recurrent restenosis group and the non‐recurrent restenosis group. The binary classifications followed the QCA standards of ISR. Clinical and angiographic characteristics of the groups were analyzed, and the QFRs before and after lesion preparation and after final DCB angioplasty were measured and compared. Results A total of 208 patients who underwent follow‐up angiography were enrolled in the study, with 226 lesions measured in total. QFR value after DCB angioplasty (odds ratio [OR] 0.88; 95% confidence interval [CI] 0.83–0.93; p < .0001 for 1 mm increase), lesion length (OR: 1.08; 95% CI: 1.01–1.15; p = .017), and vessel caliber lumen diameter (OR: 0.35; 95% CI 0.13–0.89; p = .027) were independently associated with recurrent restenosis after DCB angioplasty. The optimal QFR cut‐off value was determined to be 0.90 with a sensitivity of 0.94, specificity of 0.56, and accuracy of 0.79 in predicting recurrent restenosis. Conclusions The QFR value after DCB angioplasty is a promising predictor of DES ISR.