Validation of novel 3-dimensional quantitative coronary angiography based software to calculate fractional flow reserve post stenting

Kaneshka Masdjedi, Laurens J.C. van Zandvoort, Matthew M. Balbi, Rutger Jan Nuis, Jeroen Wilschut, Roberto Diletti, Peter P.T. de Jaegere, Felix Zijlstra, Nicolas M. Van Mieghem, Joost Daemen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

12 Citations (Scopus)
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Objectives: To validate novel dedicated 3D-QCA based on the software to calculate post PCI vessel-FFR (vFFR) in a consecutive series of patients, to assess the diagnostic accuracy, and to assess inter-observer variability. Background: Low post percutaneous coronary intervention (PCI) fractional flow reserve (FFR) predicts future adverse cardiac events. However, FFR assessment requires the insertion of a pressure wire in combination with the use of a hyperemic agent. Methods: FAST POST study is an observational, retrospective, single-center cohort study. One hundred patients presenting with stable angina or non ST-elevation myocardial infarction, who underwent post PCI FFR assessment using a dedicated microcatheter were included. Two orthogonal angiographic projections were acquired to create a 3D reconstruction of the coronary artery using the CAAS workstation 8.0. vFFR was subsequently calculated using the aortic root pressure. Results: Mean age was 65±12 years and 70% were male. Mean microcatheter based FFR and vFFR were 0.91±0.07 and 0.91±0.06, respectively. A good linear correlation was found between FFR and vFFR (r = 0.88; p <.001). vFFR had a higher accuracy in the identification of patients with FFR values <0.90, AUC 0.98 (95% CI: 0.96-1.00) as compared with 3D-QCA AUC 0.62 (95% CI: 0.94-0.74). Assessment of vFFR had a low inter-observer variability (r = 0.95; p <.001). Conclusion: 3D-QCA derived post PCI vFFR correlates well with invasively measured microcatheter based FFR and has a high diagnostic accuracy to detect FFR <0.90 with low inter-observer variability.

Original languageEnglish
Pages (from-to)671-677
Number of pages7
JournalCatheterization and Cardiovascular Interventions
Issue number4
Publication statusPublished - 6 Oct 2021

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© 2020 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.


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