January 1, 2005Circulation JournalOpen Access

Intracoronary Continuous Adenosine Infusion A Novel and Effective Way of Inducing Maximal Hyperemia for Fractional Flow Reserve Measurement

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Why the study?

Does continuous intracoronary infusion of adenosine improve the induction of maximal hyperemia for FFR measurement compared to intracoronary bolus or intravenous infusion in patients with intermediate coronary artery stenosis?

Population

50 patients with an angiographically intermediate lesion in a major epicardial coronary artery. Exclusions…

Comparison

Continuous intracoronary infusion of adenosine. vs Intracoronary bolus injection of adenosine and…

Design

Cohort

Authors

BKBon‐Kwon KooInterventional Cardiology CKCheol-Ho KimApple (Israel)SNSang-Hun NaNew Generation University College

Discussion

Member takes

Implication

IC bolus yields higher FFR than continuous infusions; hypothesis-generating for continuous IC adenosine but should not yet change FFR practice.

Structured PICO

Population

50 patients with an angiographically intermediate lesion (visual estimation: 50-75%) in a major epicardial coronary artery. Exclusions included visible collateral flow, myocardial infarction, unstable clinical condition, regional wall motion abnormalities, reduced left ventricular systolic function, left ventricular hypertrophy, or arrhythmia.

Intervention

Continuous intracoronary (IC) infusion of adenosine (Phase I evaluated 180, 240, and 300 μg/min; Phase II used 240 μg/min).

Comparator

Intracoronary bolus injection of adenosine (40 μg for RCA, 80 μg for LAD/LCX) and intravenous (IV) continuous infusion of adenosine (140 μg/kg/min).

Outcome

Hyperemic efficacy as measured by Fractional Flow Reserve (FFR).surrogate

Continuous intracoronary infusion of adenosine at 240 μg/min is a safe and effective method for inducing maximal hyperemia for FFR measurement, providing comparable efficacy to intravenous infusion and superior efficacy to intracoronary bolus injection.

Limitations

Requires proper engagement of the guiding catheter and cannot be done with a catheter that has side holes.
Hyperemic efficacy was compared only with bolus injection and IV infusion of adenosine, not with ATP or papaverine.
Performed only in patients with a stable condition and normal left ventricular function.
All enrolled patients had intermediate stenosis; plateau time in normal coronary arteries is unknown.

Cite This Study

Koo et al. (2005) studied this question.

synapsesocial.com/papers/6a7652a83bd31deb7eb1c2a2 https://doi.org/10.1253/circj.69.908

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Implication

IC bolus yields higher FFR than continuous infusions; hypothesis-generating for continuous IC adenosine but should not yet change FFR practice.

Intracoronary Continuous Adenosine Infusion A Novel and Effective Way of Inducing Maximal Hyperemia for Fractional Flow Reserve Measurement

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Intracoronary Continuous Adenosine Infusion A Novel and Effective Way of Inducing Maximal Hyperemia for Fractional Flow Reserve Measurement

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider