Korean Circ J.  2019 Nov;49(11):1022-1032. 10.4070/kcj.2019.0074.

The Current Status of Intervention for Intermediate Coronary Stenosis in the Korean Percutaneous Coronary Intervention (K-PCI) Registry

Affiliations
  • 1Department of Cardiology, Konkuk University School of Medicine, Chungju, Korea.
  • 2Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, Korea.
  • 3Division of Cardiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea.
  • 4Department of Cardiology, Pusan National University Yangsan Hospital, Busan, Korea.
  • 5Department of Cardiology, The Catholic University of Korea, Incheon St. Mary's Hospital, Incheon, Korea.
  • 6Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
  • 7Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical center, Seoul, Korea.
  • 8Division of Cardiology, The Catholic University of Korea, St.Vincent's Hospital, Suwon, Korea.
  • 9Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, Kangwon National University Hospital, Chuncheon, Korea.
  • 10Division of Cardiology, University of Inje College of Medicine, Inje University Heaundae Paik Hospital, Busan, Korea.
  • 11Division of Cardiology, University of Inje College of Medicine, Busan Paik Hospital, Busan, Korea. jsjang71@gmail.com

Abstract

BACKGROUND AND OBJECTIVES
Intermediate coronary lesion that can be under- or over-estimated by visual estimation frequently results in stenting of functionally nonsignificant lesions or deferral of percutaneous coronary intervention (PCI) of significant lesions inappropriately. We evaluated current status of PCI for intermediate lesions from a standardized database in Korea.
METHODS
We analyzed the Korean percutaneous coronary intervention (K-PCI) registry data which collected a standardized PCI database of the participating hospitals throughout the country from January 1, 2014, through December 31, 2014. Intermediate lesion was defined as a luminal narrowing between 50% and 70% by visual estimation and then compared whether the invasive physiologic or imaging study was performed or not.
RESULTS
Physiology-guided PCI for intermediate lesions was performed in 16.8% for left anterior descending artery (LAD), 9.8% for left circumflex artery (LCX), 13.2% for right coronary artery (RCA). PCI was more frequently performed using intravascular ultrasound (IVUS) than using fractional flow reserve (FFR) for coronary artery segments (27.7% vs. 13.9% for LAD, 32.9% vs. 8.1% for LCX, and 33.8% vs. 10.8% for RCA). In accordance with or without FFR, PCI for intermediate lesions was more frequently performed in the hospitals with available FFR device than without FFR, especially in left main artery (LM), proximal LAD lesion (40.9% vs. 5.9% for LM, 24.6% vs 7.6% for proximal LAD).
CONCLUSIONS
These data provide the current PCI practice pattern with the use of FFR and IVUS in intermediate lesion. More common use of FFR for intermediate lesion should be encouraged.

Keyword

Coronary artery disease; Percutaneous coronary intervention; Fractional flow reserve, myocardial
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