No Difference with Fractional Flow Reserve vs. Intravascular Ultrasound for Guiding PCI

A randomized study demonstrated similar outcomes with both approaches at 2 years, despite fewer interventions being performed with FFR guidance.

Studies demonstrate the utility of both fractional flow reserve (FFR) and intravascular ultrasound (IVUS) to guide decision making for percutaneous coronary intervention (PCI) in patients with angiographically intermediate lesions, but comparisons of clinical outcomes are lacking. In this industry-funded, multicenter study conducted in Korea and China (NCT02673424), investigators randomly assigned 1682 patients with stenosis of 40%–70% on angiography to undergo intervention based on FFR (≤0.80) or IVUS (minimal lumen area ≤3 mm², or 3–4 mm² with plaque burden >70%). The primary endpoint was death, myocardial infarction, or revascularization at 24 months.

The mean age of participants was 65 years, 33% had diabetes, and 29% were women. PCI was…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)