{"title":"Intravascular ultrasound-derived virtual fractional flow reserve in the superficial femoral artery.","authors":"Takenobu Shimada, Yoshihiro Iwasaki, Atsushi Funatsu, Tomoko Kobayashi, Shigeru Nakamura, Daiju Fukuda","doi":"10.1186/s42155-024-00513-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Fractional flow reserve (FFR) can be estimated by analysis of intravascular imaging in a coronary artery; however, there are no data for estimated FFR in an extremity artery. The aim of this concept-generating study was to determine whether it is possible to estimate the value of peripheral FFR (PFFR) by intravascular ultrasound (IVUS) analysis also in femoropopliteal artery lesions.</p><p><strong>Methods: </strong>Between April 2022 and February 2023, PFFR was measured before endovascular therapy in 31 stenotic femoropopliteal artery lesions. High-definition IVUS measurement was simultaneously performed in automatic pullback mode in 6 of those 31 lesions. IVUS-derived PFFR was calculated by an algorithm based on fluid dynamics as the following equation: ΔP = FV + SV<sup>2</sup>. F is the coefficient of pressure loss because of viscous friction (Poiseuille's equation) and S is the coefficient of local pressure loss because of flow separation (Bernoulli's equation). The values of F and S were calculated by analysis of IVUS. V is velocity and the value of V was obtained from previously reported data in a duplex ultrasound study. The mean pressure was assumed to be 80 mmHg, and IVUS-derived PFFR was calculated by the following equation: IVUS-derived PFFR = (80 - ΔP) / 80.</p><p><strong>Results: </strong>The values of IVUS-derived PFFR and actual PFFR were similar: 0.73 and 0.72, 0.87 and 0.92, 0.90 and 0.92, 0.66 and 0.73, and 0.79 and 0.72, respectively. In one case in which run-off of the below-the-knee artery was poor, PFFR (0.91) was higher than the IVUS-derived PFFR (0.73).</p><p><strong>Conclusion: </strong>Virtual PFFR in the superficial femoral artery can be estimated from IVUS analysis.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"7 1","pages":"92"},"PeriodicalIF":1.2000,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671458/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"CVIR Endovascular","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s42155-024-00513-y","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
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Abstract
Background: Fractional flow reserve (FFR) can be estimated by analysis of intravascular imaging in a coronary artery; however, there are no data for estimated FFR in an extremity artery. The aim of this concept-generating study was to determine whether it is possible to estimate the value of peripheral FFR (PFFR) by intravascular ultrasound (IVUS) analysis also in femoropopliteal artery lesions.
Methods: Between April 2022 and February 2023, PFFR was measured before endovascular therapy in 31 stenotic femoropopliteal artery lesions. High-definition IVUS measurement was simultaneously performed in automatic pullback mode in 6 of those 31 lesions. IVUS-derived PFFR was calculated by an algorithm based on fluid dynamics as the following equation: ΔP = FV + SV2. F is the coefficient of pressure loss because of viscous friction (Poiseuille's equation) and S is the coefficient of local pressure loss because of flow separation (Bernoulli's equation). The values of F and S were calculated by analysis of IVUS. V is velocity and the value of V was obtained from previously reported data in a duplex ultrasound study. The mean pressure was assumed to be 80 mmHg, and IVUS-derived PFFR was calculated by the following equation: IVUS-derived PFFR = (80 - ΔP) / 80.
Results: The values of IVUS-derived PFFR and actual PFFR were similar: 0.73 and 0.72, 0.87 and 0.92, 0.90 and 0.92, 0.66 and 0.73, and 0.79 and 0.72, respectively. In one case in which run-off of the below-the-knee artery was poor, PFFR (0.91) was higher than the IVUS-derived PFFR (0.73).
Conclusion: Virtual PFFR in the superficial femoral artery can be estimated from IVUS analysis.
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