Clinical Presentation:

• Chest pain for two days, aggravated for two hours

Angiographic Findings:

• Prox-LAD bifurcation lesion, 70%-80% stenosis

• Ostial Diagonal 60%-70% stenosis

Evaluation Strategy:

• prox-LAD and Ostial Diagonal stenosis evaluated by RainMed’s caFFR

• PCI priority is given to blood vessel with lower caFFR value

• After PCI, use RainMed’s caFFR for postoperative review

caFFR Value:

• caFFR of prox-LAD: 0.75

• caFFR of Ostial Diagonal: 0.85

Procedure Strategy:

• Stent for prox-LAD

• Ostial Diagonal does not need PCI

Postoperative Review:

• caFFR of prox-LAD: 0.95

• caFFR of Ostial Diagonal: 0.81

Case Summary:

This case fully demonstrates caFFR's advantage in the assessment of bifurcation lesions. With prox-LAD already treated with a stent during postoperative review, using a conventional pressure guidewire for Ostial Diagonal FFR measurement would require a second intervention treatment where the guidewire passes through the stent and then into the bifurcation, which is difficult to perform and might damage the vascular. By using caFFR to assess the Ostial Diagonal lesion, FFR values can be obtained directly based on angiograms without the need for guidewire, secondary intervention treatment and retraction, which reduces surgical risk, increases surgical efficiency, and assists doctors to formulate more accurate diagnosis and treatment strategies.

Coronary intervention has entered an era of precision diagnosis. caFFR system, independently developed by RainMed Medical, is able to guide PCI without any guidewire or hyperemic agents. It can perform simple and accurate functional assessment of coronary arteries, and conduct the postoperative review after PCI. Therefore, it is a favorable alternative to guidewire-based FFR and a better choice for doctors. In the future, RainMed Medical will uphold the purpose of "Targeted Medical Services for People's Health", continue to launch its world-first coronary angiography-derived Index of Microcirculatory Resistance -- caIMR, which can overcome the technical difficulties of guidewire-derived IMR, improve the efficiency of functional measurement of coronary microcirculation, and open a new era of clinical non-interventional coronary microcirculation diagnosis.