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Turkish Society of Cardiology
Young Cardiologists
President
Dr. Muzaffer Değertekin
Coordinator for the
Board of Directors
Dr. Ertuğrul Okuyan
Coordinator for the
Board of Directors
Dr. Can Yücel Karabay
Members
Dr. Adem Aktan
Dr. Gülşah Aktüre
Dr. Bayram Arslan
Dr. İnanç Artaç
Dr. Ahmet Oğuz Aslan
Dr. Görkem Ayhan
Dr. Ahmet Anıl Başkurt
Dr. Özkan Bekler
Dr. Oğuzhan Birdal
Dr. Yusuf Bozkurt Şahin
Dr. Serkan Bulgurluoğlu
Dr. Ümit Bulut
Dr. Veysi Can
Dr. Mustafa Candemir
Dr. Murat Çap
Dr. Göksel Çinier
Dr. Ali Çoner
Dr. Yusuf Demir
Dr. Ömer Furkan Demir
Dr. Murat Demirci
Dr. Ayşe İrem Demirtola Mammadli
Dr. Süleyman Çağan Efe
Dr. Mehmet Akif Erdöl
Dr. Kubilay Erselcan
Dr. Kerim Esenboğa
Dr. Duygu Genç
Dr. Kemal Göçer
Dr. Elif Güçlü
Dr. Arda Güler
Dr. Duygu İnan
Dr. Hasan Burak İşleyen
Dr. Muzaffer Kahyaoğlu
Dr. Sedat Kalkan
Dr. Yücel Kanal
Dr. Özkan Karaca
Dr. Ahmet Karaduman
Dr. Mustafa Karanfil
Dr. Ayhan Kol
Dr. Fatma Köksal
Dr. Mevlüt Serdar Kuyumcu
Dr. Yunus Emre Özbebek
Dr. Ahmet Özderya
Dr. Yasin Özen
Dr. Ayşenur Özkaya İbiş
Dr. Çağlar Özmen
Dr. Selvi Öztaş
Dr. Hasan Sarı
Dr. Serkan Sivri
Dr. Ali Uğur Soysal
Dr. Hüseyin Tezcan
Dr. Nazlı Turan
Dr. Berat Uğuz
Dr. Örsan Deniz Urgun
Dr. İdris Yakut
Dr. Mustafa Yenerçağ
Dr. Mehmet Fatih Yılmaz
Dr. Yakup Yiğit
Dr. Mehmet Murat Yiğitbaşı
Bulletin Editors
Dr. Muzaffer Değertekin
Dr. Can Yücel Karabay
Dr. Muzaffer Kahyaoğlu
Contributors
Dr. Ahmet Caner Canpolat
Dr. Aysu Oktay
Dr. Hadi Verdiyev
Dr. Kemal Göçer
Dr. Mehmet Altunova
Dr. Mehmet Murat Yiğitbaşı
Dr. Merve Kapçık
Dr. Muhammed Ali Söyler
Dr. Muhammet Ali Ekiz
Dr. Mustafa Yenerçağ
Dr. Mustafa Yılmaz
Dr. Özkan Karaca
Dr. Ramazan Furkan Demirkıran
Dr. Seda Kurat Güldoğmuş
Dr. Sefa Sarı
Dr. Selim Süleyman Sert
Dr. Serkan Bulguroğlu
Dr. Ülkü Nur Koç
Dr. Yücel Kanal
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Long-Term Outcomes After PCI Guided by Imaging and Physiology: Extended Follow-up of the FLAVOUR StudyTürk Kardiyoloji Derneği Genç Kardiyologlar Bülteni - Long-Term Outcomes After PCI Guided by Imaging and Physiology: Extended Follow-up of the FLAVOUR Study (Dr. Mustafa Yılmaz, Dr. Mustafa Yenerçağ)Prepared by: Dr. Mustafa Yılmaz, Dr. Mustafa Yenerçağ
Study Title: Long-Term Outcomes After PCI Guided by Imaging and Physiology: Extended Follow-up of the FLAVOUR Study
Presented at: EuroPCR 2025
Link: https://www.pcronline.com/Cases-resources-images/Resources/Course-videos-slides?date=2025
Introduction
Intravascular imaging and physiological assessment play an important role in decision-making and optimization in the management of coronary artery disease. Imaging modalities such as IVUS or OCT are recommended when performing PCI in anatomically complex areas such as the left main coronary artery, bifurcations, and long lesions. The use of FFR or iFR is recommended to guide revascularization decisions in cases of intermediate stenosis. The FLAVOUR study was designed to compare long-term outcomes of IVUS versus FFR guidance in the management of coronary artery disease.
Objective
The aim of the study is to compare FFR- and IVUS-guided strategies in decision-making and procedural optimization in patients with intermediate coronary stenosis.
Methods
The FLAVOUR study is a multicenter, international, randomized trial. In this extended follow-up, 1,682 patients with intermediate coronary stenosis were retrospectively analyzed and randomized in a 1:1 ratio to either the FFR (n=838) or IVUS (n=844) group. The median follow-up duration was 6.3 years. The primary endpoint was patient-oriented composite outcomes, including all-cause death, myocardial infarction (MI), or the need for repeat revascularization, and vessel-oriented composite outcomes including target vessel-related death, target vessel MI, and target vessel revascularization.
Results
The primary endpoint of patient-oriented composite outcomes was 20.9% in the IVUS group and 23% in the FFR group. The all-cause mortality rates were 9.1% and 9.2%, respectively. MI rates were 2.3% and 3.4%, respectively. The only statistically significant difference was in repeat revascularization, with rates of 11.8% in the IVUS group and 14.9% in the FFR group (HR: 0.76, P= 0.049). In vessel-oriented outcomes, although target vessel revascularization was initially lower in the FFR group during the first two years, it increased over time in the long term. Nevertheless, the overall target vessel PCI burden was significantly lower in the FFR group.
Conclusion
The data show that long-term patient-oriented clinical outcomes were similar between FFR- and IVUS-guided strategies.
Comment
This study demonstrates that both FFR- and IVUS-guided strategies yield similar long-term patient-oriented outcomes in patients with intermediate coronary artery lesions. The FFR-guided approach initially requires fewer interventions and reduces the overall PCI burden over time. The IVUS-guided approach may be more advantageous in the long term, particularly in reducing the need for repeat revascularization. Clinical decisions between these two strategies can be individualized based on patient characteristics and lesion anatomy.
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