| Abstract [eng] |
Diffuse coronary artery disease represents complex lesions, presenting a persistent challenge for effective treatment even in contemporary cardiology. Sole reliance on medication often proves insufficient to alleviate angina symptoms, while percutaneous coronary intervention (PCI) is frequently associated with suboptimal functional outcomes and an increased incidence of adverse events related to the treated vessel. Consequently, aorto-coronary bypass surgery is frequently chosen for the treatment of long coronary lesions, despite a lack of evidence supporting the superiority of this approach. Additional tools such as fractional flow reserve (FFR) and intravascular ultrasound (IVUS) enable the optimization of interventions, frequently enhancing their efficacy and reducing the risk of adverse events in the long term. However, the optimal PCI optimization strategy remains unclear, given the lack of studies comparing these two PCI optimization tools. This study represents the first evaluation of postprocedural and long-term functional outcomes following IVUS-guided PCI for long coronary artery lesions. Furthermore, it compares, for the first time, two distinct PCI optimization strategies (IVUS and FFR) in the treatment of long coronary artery lesions. The findings indicate a significantly lower incidence of residual myocardial ischemia immediately after PCI and in the remote period in the IVUS optimization group compared to the FFR optimization group. Additionally, a trend towards fewer adverse events was observed in the IVUS group compared to the FFR optimization group. Based on these research results, recommendations for clinical practice are provided. |
