The Current Status of Intervention for Intermediate Coronary Stenosis in the Korean Percutaneous Coronary Intervention (K-PCI) Registry.
BACKGROUND AND OBJECTIVES
Intermediate coronary lesion that can be under- or over-estimated by visual estimation frequently results in stenting of functionally nonsignificant lesions or deferral of percutaneous coronary intervention (PCI) of significant lesions inappropriately. We evaluated current status of PCI for intermediate lesions from a standardized database in Korea.


METHODS
We analyzed the Korean percutaneous coronary intervention (K-PCI) registry data which collected a standardized PCI database of the participating hospitals throughout the country from January 1, 2014, through December 31, 2014. Intermediate lesion was defined as a luminal narrowing between 50% and 70% by visual estimation and then compared whether the invasive physiologic or imaging study was performed or not.


RESULTS
Physiology-guided PCI for intermediate lesions was performed in 16.8% for left anterior descending artery (LAD), 9.8% for left circumflex artery (LCX), 13.2% for right coronary artery (RCA). PCI was more frequently performed using intravascular ultrasound (IVUS) than using fractional flow reserve (FFR) for coronary artery segments (27.7% vs. 13.9% for LAD, 32.9% vs. 8.1% for LCX, and 33.8% vs. 10.8% for RCA). In accordance with or without FFR, PCI for intermediate lesions was more frequently performed in the hospitals with available FFR device than without FFR, especially in left main artery (LM), proximal LAD lesion (40.9% vs. 5.9% for LM, 24.6% vs 7.6% for proximal LAD).


CONCLUSIONS
These data provide the current PCI practice pattern with the use of FFR and IVUS in intermediate lesion. More common use of FFR for intermediate lesion should be encouraged.
['Kim|Jin Ho|JH|https://orcid.org/0000-0003-3585-7859', 'Choi|Woonggil|W|https://orcid.org/0000-0002-2235-8041', 'Kim|Ki Chang|KC|https://orcid.org/0000-0003-0610-2502', 'Nam|Chang Wook|CW|https://orcid.org/0000-0002-3370-5774', 'Hong|Bum Kee|BK|https://orcid.org/0000-0002-6456-0184', 'Kim|June Hong|JH|https://orcid.org/0000-0002-9973-2177', 'Jeon|Doo Soo|DS|https://orcid.org/0000-0001-6270-6621', 'Bae|Jang Whan|JW|https://orcid.org/0000-0003-1362-9804', 'Kim|Sang Hyun|SH|https://orcid.org/0000-0001-8026-1582', 'Moon|Keon Woong|KW|https://orcid.org/0000-0003-2726-3209', 'Cho|Byung Ryul|BR|https://orcid.org/0000-0003-2095-1121', 'Kim|Doo Il|DI|https://orcid.org/0000-0001-9194-6288', 'Jang|Jae Sik|JS|https://orcid.org/0000-0001-7865-124X']
Percutaneous coronary intervention Coronary artery disease Fractional flow reserve, myocardial