Comparative study of the efficacy of pressure microcatheter in the measurement of fractional flow reserve in percutaneous coronary intervention

Li Jiacong; Zhang Xiaojuan; Yu Longhui; Tu Weiling; Cai Lu; Hu Tao; Deng Hui; Wang Sheng; Li Linfeng

doi:10.3969/j.issn.1674-4055.2025.02.18

Abstract：Objective To explore the effect of fractional flow reserve measured by pressure microcatheter in coronary intervention.Methods This study retrospectively collected 179 patients with borderline coronary artery disease in single coronary artery who were hospitalized in Jiangxi Provincial People's Cardiology Department from December 2020 to December 2022 and underwent percutaneous coronary intervention guided by fractional flow reserve.The patients were divided into pressure guidewire group(n=55)and pressure microcatheter group(n=55)at a ratio of 1∶1.The main observation indicators were intraoperative vascular lesions,contrast agent dosage,operation time,intraoperative complications and postoperative adverse cardiovascular events.Results A total of 110 patients who underwent percutaneous coronary intervention(PCI)using either a pressure guidewire or a pressure microcatheter were included in this study.There was no significant difference in age,gender,height,or other general clinical data between the pressure guidewire and the pressure microcatheter groups(P＞0.05).The comparison of surgical data showed that there were no significant differences in stent implantation diameter and length,preoperative and postoperative FFR,and diseased vessels between the two groups(P＞0.05).The operation time of the pressure microcatheter group was shorter than that of the pressure guidewire group[(62.62±11.08)min vs.(73.24±18.59)min,P＜0.05],and the amount of contrast medium in the pressure microcatheter group was less than that in the pressure guidewire group[(70.27±11.48)ml vs.(76.64±11.22)ml,P＜0.05].The two groups had no significant differences in intraoperative complications and postoperative adverse cardiovascular events(P＞0.05).Univariate analysis showed that postoperative FFR,diabetes,drinking history,intraoperative complications and LDL-C had statistically significant effects on postoperative adverse cardiovascular events(P＜0.05).Age,height,weight,TG,TC,preoperative FFR,operation time,contrast agent dosage,stent diameter and length,gender,antiplatelet drug use,diabetes,hypertension,drinking history and other factors had no statistically significant effect on postoperative adverse cardiovascular events(P＞0.05).Multivariate Cox regression analysis showed that LDL-C(HR=1.09,95％CI:1.00～1.18),postoperative FFR(HR=0.70,95％CI:0.56～0.88),intraoperative complications(HR=4.60,95％CI:1.41～15.06)were independent predictors of adverse cardiovascular events(P＜0.05).Conclusions Compared with the pressure guidewire,the pressure microcatheter does not increase the risk of short-term major adverse cardiovascular events in coronary fractional flow reserve surgery,and it helps to shorten the operation time,reduce the dosage of contrast agents.