Issue: Vojnosanit Pregl 2016; Vol. 73 (No. 6)

Clinical use of optical coherence tomography and fractional flow reserve

Authors:
Vladimir Ivanović*†, Milovan Petrović*†, Milenko Čanković*†, Anastazija Stojšić-Milosavljević*†, Snežana Čemerlić*

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Introduction. The aim of each diagnostic method is to
serve as a guide in deciding about the right patient treatment.
During myocardial revascularization the decision to
perform revascularization is usually not easy to make, especially
in case of borderline stenosis. It has been proven that
it is not enough to base morphological evaluation of coronary
artery vessel stenosis solely on angiography. It is necessary
to include additional modern diagnostic methods for
functional analysis and detailed morphological analysis using
fractional flow reserve (FFR) and optical coherence tomography
(OCT), respectively. Case reports. In the first case
report we showed the significance of morphological analysis
using OCT and proved that it was not lumen stenosis. The
second and the third case reports showed the complementarity
between functional analysis (FFR) and morphological
analysis (OCT) of stenosis in solving a complex coronary
disease. The fourth case report showed the significance of
OCT in dealing with the recurrent stent restenosis. Conclusion.
By these short case reports we confirmed that percutaneous
coronary intervention (PCI) guided by angiography
is definitely not enough in deciding about myocardial
revascularization especially in patients with a complex
coronary disease. In certain cases FFR and OCT procedures
can be complementary methods and improve quality
of revascularization, particularly in case of recurrent instent
restenosis.