Prospective Evaluation of the Strategy of Functionally Optimized Coronary Intervention.

Background Long-term outcomes after percutaneous coronary intervention (PCI) relate in part to residual ischemia in the treated vessel, as reflected by post-PCI fractional flow reserve (FFR). The strategy of FFR after PCI and treatment of residual ischemia-known as functionally optimized coronary intervention (FCI)-may be feasible and capable of improving outcomes. Methods and Results Feasibility and results of FCI using an optical-sensor pressure wire were prospectively evaluated in an all-comer population with 50% to 99% lesions and ischemic FFR (≤0.80; ClinicalTrials.gov identifier NCT03227588). FCI was attempted in 250 vessels in 226 consecutive patients. The PCI success rate was 99.6% (249/250 vessels). FCI technical success-that is, FFR before and after PCI and PCI itself using the FFR wire-was 92% (230/250 vessels). Incidence of residual ischemia in the treated vessel was 36.5%. Approximately a third of these vessels (34.5%, n=29) were considered appropriate for further intervention, with FFR increasing from 0.71±0.07 to 0.81±0.06 (