Initial experience with the use of fractional flow reserve in the hemodynamic evaluation of transplant renal artery stenosis
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | https://repositorio.unifesp.br/handle/11600/55917 http://dx.doi.org/10.1002/ccd.27476 |
Resumo: | ObjectiveTo describe and standardize an original protocol for fractional flow reserve (FFR) pre and postangioplasty in an initial series of patients with clinically manifested transplant renal artery stenosis (TRAS). BackgroundThere is no data in the literature about the use of FFR in TRAS. MethodsPatients with TRAS detected in a noninvasive study were referred to diagnostic angiography and stenosis considered visually severe ( 60%) were included. After selective cannulation, a PressureWire 0.014 (CertusSt. Jude Medical) was advanced to the distal portion of the vessel. Resting Pd/Pa ratio (ratio of mean distal to lesion and mean proximal pressures) and translesional systolic pressure gradient were obtained and FFR and hyperemic translesional systolic and mean pressure gradients (HSG and HMG) were registered after papaverine induced maximum hyperemiapre and poststent implantation. Creatinine levels and office blood pressure measurements were registered at the baseline, 6 and 12months after intervention. ResultsTen consecutive patients had successful stent implantation and were included. After treatment, significant increase in FFR (0.760.09 vs. 0.96 +/- 0.04, P<0.001) and reduction in systolic hyperemic gradients (-41.40 +/- 19.18, P<0.001) and mean (-24.00 +/- 11.65, P<0.001) were observed. A strong negative correlation was observed between FFR and percent stenosis diameter%SD (r=-0.89, P<0.001) and HSG (r=-0.9, P<0.001) as well as a strong positive correlation between FFR and baseline Pd/Pa ratio (r=0.9, P<0.001). ConclusionFFR was a well-tolerated, valid and reproducible tool during percutaneous intervention for TRAS. Good correlation was observed between FFR and others hemodynamic parameters of lesion severity. |
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Gomes Junior, Manuel Pereira Marques [UNIFESP]Alves, Claudia Maria Rodrigues [UNIFESP]Barbosa, Adriano Henrique Pereira [UNIFESP]Caixeta, Adriano [UNIFESP]Batista, Marcelo Costa [UNIFESP]Pestana, Jose Osmar Medina [UNIFESP]Carvalho, Antonio Carlos [UNIFESP]2020-07-20T16:31:22Z2020-07-20T16:31:22Z2018Catheterization And Cardiovascular Interventions. Hoboken, v. 91, n. 4, p. 820-826, 2018.1522-1946https://repositorio.unifesp.br/handle/11600/55917http://dx.doi.org/10.1002/ccd.2747610.1002/ccd.27476WOS:000427237000026ObjectiveTo describe and standardize an original protocol for fractional flow reserve (FFR) pre and postangioplasty in an initial series of patients with clinically manifested transplant renal artery stenosis (TRAS). BackgroundThere is no data in the literature about the use of FFR in TRAS. MethodsPatients with TRAS detected in a noninvasive study were referred to diagnostic angiography and stenosis considered visually severe ( 60%) were included. After selective cannulation, a PressureWire 0.014 (CertusSt. Jude Medical) was advanced to the distal portion of the vessel. Resting Pd/Pa ratio (ratio of mean distal to lesion and mean proximal pressures) and translesional systolic pressure gradient were obtained and FFR and hyperemic translesional systolic and mean pressure gradients (HSG and HMG) were registered after papaverine induced maximum hyperemiapre and poststent implantation. Creatinine levels and office blood pressure measurements were registered at the baseline, 6 and 12months after intervention. ResultsTen consecutive patients had successful stent implantation and were included. After treatment, significant increase in FFR (0.760.09 vs. 0.96 +/- 0.04, P<0.001) and reduction in systolic hyperemic gradients (-41.40 +/- 19.18, P<0.001) and mean (-24.00 +/- 11.65, P<0.001) were observed. A strong negative correlation was observed between FFR and percent stenosis diameter%SD (r=-0.89, P<0.001) and HSG (r=-0.9, P<0.001) as well as a strong positive correlation between FFR and baseline Pd/Pa ratio (r=0.9, P<0.001). ConclusionFFR was a well-tolerated, valid and reproducible tool during percutaneous intervention for TRAS. Good correlation was observed between FFR and others hemodynamic parameters of lesion severity.Univ Fed Sao Paulo, Div Cardiol, Intervent Cardiol Catheterizat Lab Unit, Escola Paulista Med,UNIFESP,EPM, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Nefrol, Escola Paulista Med, UNIFESP,EPM, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Div Cardiol, Escola Paulista Med, UNIFESP,EPM, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Div Cardiol, Intervent Cardiol Catheterizat Lab Unit, Escola Paulista Med,UNIFESP,EPM, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Nefrol, Escola Paulista Med, UNIFESP,EPM, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Div Cardiol, Escola Paulista Med, UNIFESP,EPM, Sao Paulo, SP, BrazilWeb of Science820-826engWileyCatheterization And Cardiovascular Interventionsangioplastyfractional flow reservekidney transplantationrenal artery obstructionInitial experience with the use of fractional flow reserve in the hemodynamic evaluation of transplant renal artery stenosisinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleHobokenv. 914info:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP11600/559172022-02-03 11:55:37.694metadata only accessoai:repositorio.unifesp.br:11600/55917Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652022-02-03T14:55:37Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Initial experience with the use of fractional flow reserve in the hemodynamic evaluation of transplant renal artery stenosis |
title |
Initial experience with the use of fractional flow reserve in the hemodynamic evaluation of transplant renal artery stenosis |
spellingShingle |
Initial experience with the use of fractional flow reserve in the hemodynamic evaluation of transplant renal artery stenosis Gomes Junior, Manuel Pereira Marques [UNIFESP] angioplasty fractional flow reserve kidney transplantation renal artery obstruction |
title_short |
Initial experience with the use of fractional flow reserve in the hemodynamic evaluation of transplant renal artery stenosis |
title_full |
Initial experience with the use of fractional flow reserve in the hemodynamic evaluation of transplant renal artery stenosis |
title_fullStr |
Initial experience with the use of fractional flow reserve in the hemodynamic evaluation of transplant renal artery stenosis |
title_full_unstemmed |
Initial experience with the use of fractional flow reserve in the hemodynamic evaluation of transplant renal artery stenosis |
title_sort |
Initial experience with the use of fractional flow reserve in the hemodynamic evaluation of transplant renal artery stenosis |
author |
Gomes Junior, Manuel Pereira Marques [UNIFESP] |
author_facet |
Gomes Junior, Manuel Pereira Marques [UNIFESP] Alves, Claudia Maria Rodrigues [UNIFESP] Barbosa, Adriano Henrique Pereira [UNIFESP] Caixeta, Adriano [UNIFESP] Batista, Marcelo Costa [UNIFESP] Pestana, Jose Osmar Medina [UNIFESP] Carvalho, Antonio Carlos [UNIFESP] |
author_role |
author |
author2 |
Alves, Claudia Maria Rodrigues [UNIFESP] Barbosa, Adriano Henrique Pereira [UNIFESP] Caixeta, Adriano [UNIFESP] Batista, Marcelo Costa [UNIFESP] Pestana, Jose Osmar Medina [UNIFESP] Carvalho, Antonio Carlos [UNIFESP] |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Gomes Junior, Manuel Pereira Marques [UNIFESP] Alves, Claudia Maria Rodrigues [UNIFESP] Barbosa, Adriano Henrique Pereira [UNIFESP] Caixeta, Adriano [UNIFESP] Batista, Marcelo Costa [UNIFESP] Pestana, Jose Osmar Medina [UNIFESP] Carvalho, Antonio Carlos [UNIFESP] |
dc.subject.eng.fl_str_mv |
angioplasty fractional flow reserve kidney transplantation renal artery obstruction |
topic |
angioplasty fractional flow reserve kidney transplantation renal artery obstruction |
description |
ObjectiveTo describe and standardize an original protocol for fractional flow reserve (FFR) pre and postangioplasty in an initial series of patients with clinically manifested transplant renal artery stenosis (TRAS). BackgroundThere is no data in the literature about the use of FFR in TRAS. MethodsPatients with TRAS detected in a noninvasive study were referred to diagnostic angiography and stenosis considered visually severe ( 60%) were included. After selective cannulation, a PressureWire 0.014 (CertusSt. Jude Medical) was advanced to the distal portion of the vessel. Resting Pd/Pa ratio (ratio of mean distal to lesion and mean proximal pressures) and translesional systolic pressure gradient were obtained and FFR and hyperemic translesional systolic and mean pressure gradients (HSG and HMG) were registered after papaverine induced maximum hyperemiapre and poststent implantation. Creatinine levels and office blood pressure measurements were registered at the baseline, 6 and 12months after intervention. ResultsTen consecutive patients had successful stent implantation and were included. After treatment, significant increase in FFR (0.760.09 vs. 0.96 +/- 0.04, P<0.001) and reduction in systolic hyperemic gradients (-41.40 +/- 19.18, P<0.001) and mean (-24.00 +/- 11.65, P<0.001) were observed. A strong negative correlation was observed between FFR and percent stenosis diameter%SD (r=-0.89, P<0.001) and HSG (r=-0.9, P<0.001) as well as a strong positive correlation between FFR and baseline Pd/Pa ratio (r=0.9, P<0.001). ConclusionFFR was a well-tolerated, valid and reproducible tool during percutaneous intervention for TRAS. Good correlation was observed between FFR and others hemodynamic parameters of lesion severity. |
publishDate |
2018 |
dc.date.issued.fl_str_mv |
2018 |
dc.date.accessioned.fl_str_mv |
2020-07-20T16:31:22Z |
dc.date.available.fl_str_mv |
2020-07-20T16:31:22Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
Catheterization And Cardiovascular Interventions. Hoboken, v. 91, n. 4, p. 820-826, 2018. |
dc.identifier.uri.fl_str_mv |
https://repositorio.unifesp.br/handle/11600/55917 http://dx.doi.org/10.1002/ccd.27476 |
dc.identifier.issn.none.fl_str_mv |
1522-1946 |
dc.identifier.doi.none.fl_str_mv |
10.1002/ccd.27476 |
dc.identifier.wos.none.fl_str_mv |
WOS:000427237000026 |
identifier_str_mv |
Catheterization And Cardiovascular Interventions. Hoboken, v. 91, n. 4, p. 820-826, 2018. 1522-1946 10.1002/ccd.27476 WOS:000427237000026 |
url |
https://repositorio.unifesp.br/handle/11600/55917 http://dx.doi.org/10.1002/ccd.27476 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.none.fl_str_mv |
Catheterization And Cardiovascular Interventions |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
820-826 |
dc.coverage.none.fl_str_mv |
Hoboken |
dc.publisher.none.fl_str_mv |
Wiley |
publisher.none.fl_str_mv |
Wiley |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
|
_version_ |
1802764146553389056 |