Application of quantitative flow ratio in radial artery grafting
10.3760/cma.j.cn112434-20241125-00293
- VernacularTitle:定量血流比在桡动脉冠状动脉旁路移植术中的应用
- Author:
Zhaopeng ZHONG
1
;
Ping BO
1
;
Ping LI
1
;
Guohui HUANG
1
;
Guanglong SUN
1
Author Information
1. 首都医科大学附属北京安贞医院心脏外科中心，北京 100029
- Publication Type:Journal Article
- Keywords:
Quantitative flow ratio;
Radial artery;
Coronary artery bypass graft;
Major adverse cardiovascular events;
Graft patency
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2025;41(5):271-275
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the use of quantitative flow ratio(QFR) for selecting suitable anastomosis targets of radial artery in coronary artery bypass grafting.Methods:From January 2019 to June 2023, clinical data of patients undergoing coronary artery bypass grafting with using radial artery obtained from Beijing Anzhen Hospital were retrospectively collected. A total of 186 patients were included in this study, including 175 males and 11 females. The average age was(54.26±7.91) years, ranging from 34 to 70 years. They were divided into study group(n=46) and control group(n=140) according to whether QFR was examined before operation. The distal radial artery in the study group was anastomosed to a non-LAD artery with the lowest QFR value, while in the control group was randomly anastomosed to the most important non-LAD artery with the anatomic stenosis greater than 75%. All patients were followed up. The endpoint event was major adverse cardiovascular events(MACE) and radial grafts stenosis/occlusion. The preoperative baseline data, perioperative indexes and follow-up were analyzed and compared.Results:There was no significant difference in preoperative baseline data between the two groups. The pulse index(PI) in the study group was significantly lower than that in the control group(1.88±0.45 vs. 2.11±0.61, P<0.05). There were no serious perioperative complications in both groups. All patients survived and were discharged from hospital. The average follow-up time was 30 months. There were no significant differences in cardiogenic death, stroke, recurrent myocardial infarction, and revascularization between the two groups. The rate of recurrent angina in the study group was significantly lower than that in the control group(8.7% vs. 22.1%, P<0.05). The complete patency rate of radial graft in the study group was significantly higher than that in the control group(96.4% vs. 86.0%, P<0.05), the occlusion rate was significantly lower than that in the control group(0 vs. 9.4%, P<0.05), and the stenosis rate had no significant difference between two groups. Conclusion:QFR can clarify the functional changes of coronary blood flow, select suitable anastomosis target for radial graft, reduce the occurrence of competing flow, and then improve the patency rate and clinical prognosis.
