• Xiaoqing Cai, Feng Tian, Jing Jing, Qinhua Jin, Shanshan Zhou, Weijun Yin, Yufang Chen, Qiang Wu, Zhenhong Fu, and Yundai Chen.
• Department of Cardiology, PLA General Hospital, Beijing, China.
• Catheter Cardiovasc Interv. 2021 May 1; 97 Suppl 2: 1048-1054.

ObjectivesThis study aimed to evaluate prognostic value of quantitative flow ratio (QFR) in drug-coated balloon (DCB) angioplasty for in-stent restenosis (ISR).BackgroundThere is a high incidence of recurrent ISR after DCB angioplasty. QFR is a novel method for fast computation of fractional flow reserve for the target vessel based on quantitative coronary angiography (QCA) and fluid dynamics algorithms.MethodsPatients participating in the RESTORE ISR China randomized trial were enrolled and classified into the recurrent restenosis group and the non-recurrent restenosis group. The binary classifications followed the QCA standards of ISR. Clinical and angiographic characteristics of the groups were analyzed, and the QFRs before and after lesion preparation and after final DCB angioplasty were measured and compared.ResultsA total of 208 patients who underwent follow-up angiography were enrolled in the study, with 226 lesions measured in total. QFR value after DCB angioplasty (odds ratio [OR] 0.88; 95% confidence interval [CI] 0.83-0.93; p < .0001 for 1 mm increase), lesion length (OR: 1.08; 95% CI: 1.01-1.15; p = .017), and vessel caliber lumen diameter (OR: 0.35; 95% CI 0.13-0.89; p = .027) were independently associated with recurrent restenosis after DCB angioplasty. The optimal QFR cut-off value was determined to be 0.90 with a sensitivity of 0.94, specificity of 0.56, and accuracy of 0.79 in predicting recurrent restenosis.ConclusionsThe QFR value after DCB angioplasty is a promising predictor of DES ISR.© 2021 Wiley Periodicals LLC.

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