Abstract 14528: Diagnostic Value of Fractional Flow Reserve in Aorto-Iliac Lesion; Comparison With Post Exercise Ankle Brachial Index
Introduction: Post-exercise ankle brachial index (Ex. ABI) is an essential testing for symptomatic peripheral artery disease patients with normal or borderline resting ABI. But a typical claudication doesn’t always occur in patients with co-morbidity that prevent sufficient exercise to produce limb symptoms, causing underestimate of limb status. Recently, fractional flow reserve (FFR) has been used as a physiological assessment of stenosis in coronary or renal artery stenosis. However, there were no reports regarding use of FFR to evaluate severity of stenosis in aorto-iliac artery.
Hypothesis: FFR may correlate Ex. ABI and could be an alternative tool for physiological assessment of aorto-iliac artery stenosis.
Methods: Ten patients who had an accelerated peak systolic velocity in duplex ultrasound underwent baseline resting and Ex. ABI using treadmill testing (2.4km/h, 12% grade, 5min) and underwent catheter angiography for further examination. The FFR was measured using a 0.014’’ pressure guidewire and recorded with papaverine. A % change of ABI during exercise and % change of FFR with hyperemia were calculated. We evaluated the correlation between Ex. ABI and FFR with papaverine.
Results: Mean baseline resting ABI and Ex. ABI were 0.86±0.15 and 0.65±0.27, respectively. Mean % change of ABI was 25±24%. Mean FFR without and with papaverine were 0.93±0.05 and 0.71±0.15, respectively. Mean % change of FFR was 23.9±13.2%. In present analysis, a significant linear correlation was observed between Ex. ABI and FFR with papaverine (r=0.842; p=0.001) and the mean % change of ABI and the mean % change of FFR (r=0.842; p=0.001), respectively.
Conclusions: We could show that significant linear correlation between the Ex. ABI and the FFR in the patients with aorto-iliac artery disease. FFR measurement could be an alternative tool to Ex. ABI in physiological assessment of stenosis because FFR isn’t influenced by co-morbidity and limb status.
- © 2013 by American Heart Association, Inc.