{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T02:44:18Z","timestamp":1791686658759,"version":"4.3.4"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,10,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Assessing the physiological significance of stenoses with coexistent serial disease is prone to error. We aimed to use 3\u2010dimensional\u2010printing to characterize serial stenosis interplay and to derive and validate a mathematical solution to predict true stenosis significance in serial disease.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Fifty\u2010two 3\u2010dimensional\u2010printed serial disease phantoms were physiologically assessed by pressure\u2010wire pullback (\u0394\n              <jats:styled-content style=\"fixed-case\">FFR<\/jats:styled-content>\n              <jats:sub>app<\/jats:sub>\n              ) and compared with phantoms with the stenosis in isolation (\u0394\n              <jats:styled-content style=\"fixed-case\">FFR<\/jats:styled-content>\n              <jats:sub>true<\/jats:sub>\n              ). Mathematical models to minimize error in predicting\n              <jats:styled-content style=\"fixed-case\">FFR<\/jats:styled-content>\n              <jats:sub>true<\/jats:sub>\n              , the\n              <jats:styled-content style=\"fixed-case\">FFR<\/jats:styled-content>\n              in the vessel where the stenosis is present in isolation, were subsequently developed using 32 phantoms and validated in another 20 and also a clinical cohort of 30 patients with serial disease. \u0394\n              <jats:styled-content style=\"fixed-case\">FFR<\/jats:styled-content>\n              <jats:sub>app<\/jats:sub>\n              underestimated \u0394\n              <jats:styled-content style=\"fixed-case\">FFR<\/jats:styled-content>\n              <jats:sub>true<\/jats:sub>\n              in 88% of phantoms, with underestimation proportional to total\n              <jats:styled-content style=\"fixed-case\">FFR<\/jats:styled-content>\n              . Discrepancy as a proportion of \u0394\n              <jats:styled-content style=\"fixed-case\">FFR<\/jats:styled-content>\n              <jats:sub>true<\/jats:sub>\n              was 17.1% (absolute difference 0.036\u00b10.048), which improved to 2.9% (0.006\u00b10.023) using our model. In the clinical cohort, discrepancy was 38.5% (0.05\u00b10.04) with 13.3% of stenoses misclassified (using\n              <jats:styled-content style=\"fixed-case\">FFR<\/jats:styled-content>\n              &lt;0.8 threshold). Using mathematical correction, this improved to 15.4% (0.02\u00b10.03), with the proportion of misclassified stenoses falling to 6.7%.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Individual stenoses are considerably underestimated in serial disease, proportional to total\n              <jats:styled-content style=\"fixed-case\">FFR<\/jats:styled-content>\n              . We have shown within in\u00a0vitro and clinical cohorts that this error is significantly improved using a mathematical correction model, incorporating routinely available pressure\u2010wire pullback data.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.118.010279","type":"journal-article","created":{"date-parts":[[2018,10,14]],"date-time":"2018-10-14T09:00:40Z","timestamp":1539507640000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Optimal Application of Fractional Flow Reserve to Assess Serial Coronary Artery Disease: A 3D\u2010Printed Experimental Study With Clinical Validation"],"prefix":"10.1161","volume":"7","author":[{"given":"Bhavik N.","family":"Modi","sequence":"first","affiliation":[{"name":"NIHR Biomedical Research Centre and British Heart Foundation Centre of Excellence School of Cardiovascular Medicine and Sciences St Thomas\u2019 Campus King's College London London United 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