Physiologic approach for coronary intervention.
- Author:
William F FEARON
1
Author Information
- Publication Type:Review
- Keywords: Coronary disease; Coronary physiology
- MeSH: *Cardiac Catheterization; Coronary Artery Disease/complications/*diagnosis/physiopathology/therapy; *Coronary Circulation; Fractional Flow Reserve, Myocardial; *Hemodynamics; Humans; Patient Selection; Percutaneous Coronary Intervention; Predictive Value of Tests; Treatment Outcome
- From:The Korean Journal of Internal Medicine 2013;28(1):1-7
- CountryRepublic of Korea
- Language:English
- Abstract: When invasively assessing coronary artery disease, the primary goal should be to determine whether the disease is causing a patient's symptoms and whether it is likely to cause future cardiac events. The presence of myocardial ischemia is our best gauge of whether a lesion is responsible for symptoms and likely to result in a future cardiac event. In the catheterization laboratory, fractional flow reserve (FFR) measured with a coronary pressure wire is the reference standard for identifying ischemia-producing lesions. Its spatial resolution is unsurpassed with it not only being vessel-specific, but also lesion-specific. There is now a wealth of data supporting the accuracy of measuring FFR to identify ischemia-producing lesions. FFR-guided percutaneous coronary intervention of these lesions results in improved outcomes and saves resources. Non-hemodynamically significant lesions can be safely managed medically with a low rate of subsequent cardiac events.
