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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
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How to select patients requiring coronary revascularisation using coronary physiology
1NIHR Biomedical Research Centre and British Heart Foundation Centre of Excellence, School of Cardiovascular Medicine and Sciences, St Thomas' Campus, King's College London, London, UK.
JRSM Cardiovascular Disease
|February 22, 2021
Summary
Coronary angiography assesses coronary artery disease, but coronary physiology is crucial for determining its functional significance. Advances enable
Area of Science:
- Cardiovascular medicine
- Interventional cardiology
- Medical imaging
Background:
- Coronary angiography indicates coronary artery disease but doesn't fully assess functional significance.
- Coronary physiology measurements are vital for accurate assessment.
Purpose of the Study:
- To highlight the importance of coronary physiology in assessing coronary artery disease.
- To discuss the evolution of physiological indices for lesion assessment and revascularization adequacy.
- To introduce the concept of 'Precision PCI'.
Main Methods:
- Review of advances in guidewire technology.
- Increased utilization of physiological assessments in the catheter laboratory.
- Integration of physiology with angiography and intravascular imaging.
Main Results:
- Physiological indices are evolving for reliable assessment of lesion significance.
- Assessment of revascularization adequacy is improving across clinical scenarios.
- Co-registration of physiology with imaging is becoming more accessible.
Conclusions:
- Coronary physiology is essential for functional assessment of coronary artery disease.
- Technological advancements are driving the adoption of physiological assessments.
- The future of percutaneous coronary intervention (PCI) is moving towards 'Precision PCI'.
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