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The following is a summary of “Quantitative flow ratio of the donor coronary artery supplying a chronic total occlusion territory,” published in the December 2024 issue of Cardiology by Elbasha et al.  

People with chronic total occlusion (CTO) often face challenges in assessing intermediate lesions in the donor coronary artery supplying the CTO territory despite advances in coronary physiology.  

Researchers conducted a retrospective study to evaluate the use of quantitative flow ratio (QFR) in assessing angiographically intermediate lesions of the donor coronary artery supplying a CTO territory.  

They included 219 patients with a single main donor vessel to a CTO territory from a single-center CTO registry (2017–2020). Angiographically, intermediate coronary lesions in the donor’s vessels were assessed using offline QFR before and at a median of 6 months after successful percutaneous coronary intervention (PCI) of the CTO.  

The results showed that the mean QFR value increased in the donor vessels after successful CTO revascularization (0.93 ± 0.062 vs. 0.95 ± 0.046, P<0.001) and was more prominent in donor vessels with angiographically intermediate stenosis (0.88 ± 0.063 vs. 0.92 ± 0.053, P<0.001). The change in QFR was not significant in angiographically normal donor vessels (0.97 ± 0.025 vs. 0.97 ± 0.026, P=0.814), 15 patients had hemodynamically significant stenosis in the donor coronary artery (QFR ≤ 0.80) before CTO-PCI. Among those patients, 40% (n = 6) showed non-significant lesions (QFR > 0.80) after CTO recanalization, while 30% (n = 5) patients remained significant and were treated with PCI.  

They concluded that QFR overestimated the severity of intermediate coronary lesions in donor vessels supplying a CTO territory, similar to other invasive physiology assessment methods.  

Source: link.springer.com/article/10.1007/s00392-024-02589-x