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  • 62 years old female
  • CVRF : arterial hypertension
  • ACS presentation 3 weeks ago in stress context. 
  • At admission (no chest pain)
    ECG :  ST segment depression in lateral leads
    Troponine positive (7 ng/ml)
    Echocardiography  : LVEF = 35% with apical bollooning.

Learning points

  • Functional  evaluation by FFR in coronary multivessels disease. 
  • FFR in serial multiple lesions in the same vessel. 
  •  Additional diagnostic  value of intracoronary imaging by OCT in case of borderline FFR result. 

Procedure description

  • 6Fr JR guiding catheter in the RCA.
  • FFR recording to the distal RCA ( two lesions, FFR:0.87)
  • Pullback pressure recording.
  • FFR recording to the LAD ( two FFR values : 0.81 and 0.80).
  • OCT run to the LAD showing significant  lipid-Rich plaque.
  • Stent implantation in the proximal LAD Xience Alpine 3.5x15mm.
  • OCT and FFR control  runs.

Protocol

  • Time of procedure: 16 min.
  • Radiation exposure: 0.51 Gy. 
  • Contrast volume: 190 ml Iomeon)
Shooting date : 2017-11-16
Last update : 2018-02-03
Julien Adjedj
Saint-Laurent-du-Var, France
1 comment
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  • Mayou A. Nice

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