PT  - JOURNAL ARTICLE
AU  - Mohdnazri, SR
AU  - Al-Janabi, F
AU  - Karamasis, G
AU  - Hampton-Till, J
AU  - Al-Lamee, R
AU  - Dungu, J
AU  - Gedela, S
AU  - Tang, KH
AU  - Kelly, PA
AU  - Davies, JE
AU  - Davies, R
AU  - Keeble, TR
TI  - 8 The influence of collateral regression post coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI) on donor vessel coronary pressure-derived measurements
AID  - 10.1136/heartjnl-2017-BCIS.8
DP  - 2017 Dec 01
TA  - Heart
PG  - A4--A4
VI  - 103
IP  - Suppl 7
4099  - http://heart.bmj.com/content/103/Suppl_7/A4.1.short
4100  - http://heart.bmj.com/content/103/Suppl_7/A4.1.full
SO  - Heart2017 Dec 01; 103
AB  - Background There is strong evidence of FFR-guided treatment in multi-vessel disease. The presence of a concomitant CTO may influence the FFR measurement in donor vessel. We sought to investigate the influence of collateral regression after successful CTO recanalisation on donor vessel pressure-derived indices.Methods 28 out of 34 consecutive patients underwent successful PCI to RCA CTOs and completed the follow up study (at 3 months post CTO-PCI). Resting Pd/Pa,iFR and FFR were measured pre and post successful CTO PCI and at follow-up in donor vessels.Results The mean resting Pd/Pa, iFR and FFR pre and post-RCA CTO PCI and at follow-up procedures in major donor vessel were (0.893, 0.862, 0.764), (0.907, 0.886, 0.753) and (0.918, 0.901, 0.787) respectively. The mean resting Pd/Pa, iFR and FFR pre and post-RCA CTO PCI and at follow-up procedures in minor donor vessel were (0.979, 0.966, 0.890), (0.983, 0.979, 0.880) and (0.981, 0.974, 0.898) respectively. Changes in pressure-derived indices are summarised in table 1.Abstract 8 Table 1 Changes in coronary pressure-derived measurements in donor vessel pre and post RCA CTO PCI and at fellow-up (FU: follow-up; PdPa: resting Pd/Pa; PCI: percutaneous coronary intervention; IFR: instantaneous wave-free ratio; FFR: fractional flow reserve; CTO: chronic total occlusion)Conclusion Successful recanalisation of a RCA CTO results in a significant increase in coronary pressure-derived indices of the major donor vessel at follow-up associated with a regression of collateral function. The expected change and the optimal timing to perform PCI in donor vessel should be considered when planning multi-vessel revascularisation in this setting.