Overview
Intermediate coronary artery stenosis refers to a narrowing of a coronary artery that is not severe enough to be definitively classified as significant based on visual assessment alone. Decision-making for percutaneous coronary intervention (PCI) in these lesions often requires functional or anatomical assessment to determine hemodynamic significance.Diagnosis
Functional assessment using fractional flow reserve (FFR) or intravascular imaging (IVI) can guide PCI decisions in intermediate lesions 1.
Studies have compared FFR with intravascular ultrasound (IVUS) and optical coherence tomography (OCT) 1.Management
The decision to proceed with PCI for intermediate stenosis can be guided by FFR or IVI 1.
A meta-analysis found no statistically significant difference in major adverse cardiac events (MACE) between FFR-guided and IVI-guided PCI strategies for intermediate stenosis 1.Key Recommendations
Both fractional flow reserve (FFR) and intravascular imaging (IVI) can be used to guide decision-making for percutaneous coronary intervention (PCI) in intermediate coronary stenosis 1.
There is no statistically significant difference in the incidence of major adverse cardiac events (MACE) when using FFR versus IVI to guide PCI decisions in intermediate coronary stenosis 1.
The choice between FFR and IVI for guiding PCI in intermediate lesions did not impact clinical outcomes in a meta-analysis of available studies 1.
(Evidence: Strong)References
1 Liu X, Zhang Y, Xu Y, Tang Z, Wang X, Nie S et al.. Fractional flow reserve versus intravascular imaging to guide decision-making for percutaneous coronary intervention in intermediate lesions: A meta-analysis. Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 2023. link