QFR

Drug-coated balloon treatment guided by quantitative flow ratio

A 61-year-old gentleman with a history of hypertension and dyslipidemia was admitted with recently developed minimal effort chest pain. His electrocardiogram, cardiac enzymes and echocardiography were normal but his treadmill exercise test was positive during the recovery phase. The findings were confirmed on coronary angiography with an 80% mid-LAD stenosis (Figure 1). He declined stent implantation but agreed to treatment with balloon angioplasty using a drug-coated balloon (DCB). He received a careful evaluation and obtained informed consent.

Baseline FFR at far distal of the culprit lesion was 0.68 (QFR=0.60). The lesion was dilated several times with a 3.0×15mm non-compliant balloon at 12atm and then a 3.0×26mm DCB was applied at 9atm for 60s. The final angiograms showed normal flow in the LAD with no significant dissection or residual stenosis and final FFR value was 0.87 (QFR=0.89) (Figure 2).

Figure 1. (A) Pre-procedure angiogram, QFR, FFR, (B) post-DCB angiogram, QFR, FFR.

(A)

(B)