Usefulness of functional assessment for angiographic restenosis after deployment of zotarolimus-eluting stent

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Background: It is widely recognized that late lumen loss of zotarolimus-eluting stent (ZES) was significantly higher than that of other drug-eluting stents (DES), therefore the restenosis rate and target vessel revascularization (TVR) rate after ZES deployment tend to be higher compared with those after other DES. But the patients with angiographic restenosis after ZES deployment in follow-up coronary artery angiography (CAG) are often good in the clinical course. Methods: We measured fractional flow reserve (FFR) of the coronary arteries with angiographic restenosis after ZES deployment, and assessed the usefulness of FFR measurement in decision of TVR. 25 cases (28 lesions) which were performed follow-up CAG in 62 cases (74 lesions) treated by ZES in Tokyo Medical University Hospital were enrolled. The rate of TVR which was decided by FFR measurement was evaluated. Results: Although angiographic restenosis was detected in 10 lesions, the rate of TVR based on functional assessment was 6% (4 lesions). Conclusion: Even if angiographic restenosis was detected in follow-up CAG, the cases that the functional assessment was significant and TVR was needed were 40%. Therefore, indeterminate TVR should not be performed impetuously for patients with angiographic restenosis after the deployment of ZES.