Related Experiment Video
Updated: Oct 21, 2025
10:28
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
5.4K
Physiological assessment after percutaneous coronary intervention: the hard truth
Giuseppe Zimbardo1, Pio Cialdella1, Federico DI Giusto2
1Ospedale Policlinico Casilino, Rome, Italy.
Panminerva Medica
|September 6, 2021
Summary
Physiological assessment using fractional flow reserve (FFR) or instantaneous wave free ratio (iFR) improves outcomes after percutaneous coronary intervention (PCI). Optimizing PCI based on these measures, even after visually successful procedures, is crucial for better patient results.
Area of Science:
- Cardiology
- Interventional Cardiology
- Physiological Assessment
Background:
- Physiologically guided revascularization (FFR/iFR) improves long-term outcomes compared to angiography alone.
- The role of post-percutaneous coronary intervention (PCI) physiological assessment is less established.
- Many patients with angiographically successful PCI have suboptimal functional results, impacting prognosis.
Purpose of the Study:
- To review the paradigm shift in invasive physiological assessment for PCI.
- To define the transition from pre-PCI guidance to post-PCI optimization.
- To propose a practical flowchart for physiologically optimizing PCI.
Main Methods:
- Review of existing evidence on physiological assessment in PCI.
- Analysis of the impact of functional results post-PCI.
- Development of a strategic approach for physiological optimization.
Main Results:
- Physiological assessment post-PCI can identify suboptimal results despite angiographic success.
- Accepting and addressing suboptimal physiological findings can lead to improved outcomes.
- A shift towards a comprehensive physiological approach to PCI is supported by evidence.
Conclusions:
- Invasive physiological assessment is evolving beyond pre-PCI decision-making.
- Post-PCI physiological optimization is essential for maximizing treatment benefits.
- A structured, physiological approach to PCI is recommended for improved patient care.
More Related Videos
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
48
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
48
01:26Cardiac Catheterization IV: Nursing Management
300
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
300
01:27Coronary Artery Disease V: Interprofessional Care
71
Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
71
01:28Acute Coronary Syndrome IV: Interprofessional Care
55
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
55
01:26Acute Coronary Syndrome V: Nursing Management
74
Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
74
01:27Assessment of the Cardiovascular System III: Palpation
594
Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
594