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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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Physiologic Assessment after Coronary Stent Implantation
Doyeon Hwang1, Seokhun Yang1, Jinlong Zhang2
1Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea.
Korean Circulation Journal
|March 3, 2021
Summary
Post-procedure physiologic assessment is crucial after coronary revascularization to confirm ischemia relief. This ensures percutaneous coronary intervention (PCI) effectiveness and guides further treatment for better patient outcomes.
Area of Science:
- Cardiology
- Interventional Cardiology
- Physiology
Background:
- Myocardial ischemia must be present for coronary revascularization to be beneficial.
- Physiology-guided revascularization, using fractional flow reserve and non-hyperemic pressure ratios, has demonstrated benefits.
- Residual ischemia can persist in 15-20% of cases even after angiographically successful percutaneous coronary intervention (PCI).
Purpose of the Study:
- To review the current evidence supporting post-PCI physiologic assessment.
- To guide the interpretation of post-PCI physiologic findings.
- To explore future directions in post-PCI physiologic assessment.
Main Methods:
- Review of recent randomized studies and clinical evidence.
- Analysis of diagnostic tools like fractional flow reserve and non-hyperemic pressure ratios.
- Discussion of interpretation criteria for post-PCI hemodynamic measurements.
Main Results:
- Physiology-guided revascularization does not always eliminate ischemia.
- Post-PCI assessment is vital for evaluating PCI appropriateness and identifying lesions needing further intervention.
- It aids in risk stratification after percutaneous coronary intervention.
Conclusions:
- Post-PCI physiologic assessment is essential for confirming procedural success and optimizing patient care.
- It helps in identifying residual ischemia and guiding subsequent treatment decisions.
- Further research into post-PCI assessment techniques is warranted.
Keywords:
Fractional flow reserveNon-hyperemic pressure ratioOutcomesPercutaneous coronary interventionMore Related Videos
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