Published online May 6, 2024. doi: 10.12998/wjcc.v12.i13.2269
Peer-review started: December 22, 2023
First decision: January 10, 2024
Revised: January 25, 2024
Accepted: March 20, 2024
Article in press: March 20, 2024
Published online: May 6, 2024
Invasive functional evaluation by fractional flow reserve (FFR) is considered as a gold standard for the evaluation of intermediate coronary stenosis. However, in patients with diabetes due to accelerated progression of atherosclerosis the outcome may be worse even in the presence of negative functional testing.
We present a case of 55-year-old male diabetic patient who was admitted for chest pain. Diagnostic coronary angiography disclosed 2 intermediate stenoses of the obtuse marginal branch with no evidence of restenosis on previously implanted stent. Patient undergone invasive functional testing of intermediate lesion with preserved FFR (0.88), low coronary flow reserve (1.2) and very high index of mi
Combined functional and anatomic imaging of intermediate coronary stenosis in diabetic patients represent comprehensive contemporary decision pathway in the management of the patients.
Core Tip: We present a case of the diabetic patient with moderate-to-severe coronary stenosis with preserved fractional flow reserve, low coronary flow reserve, high index of microvascular resistance and intravascular optical coherence tomography image demonstrating fibrotic plaque without signs of thin-cup fibroatheroma. Combined functional and anatomic imaging of intermediate coronary stenosis represent comprehensive contemporary decision pathway in the management of the patients.