Physiologic Lesion Assessment to Optimize Multivessel Disease.

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Imaging

Background:

• Multivessel coronary artery disease (CAD) involves significant blockages in multiple coronary arteries, leading to high rates of illness and death.
• Traditional diagnosis relied on visual assessment, but the percutaneous coronary intervention (PCI) era emphasizes functional evaluation.

Purpose of the Study:

• To review current evidence on physiologic assessment methods for multivessel coronary artery stenosis.
• To discuss commonly used techniques for functional evaluation during angiography.

Main Methods:

• Review of existing literature on coronary physiologic assessment in multivessel CAD.
• Discussion of pressure-wire-based indices and angiographically derived quantitative flow ratio.

Main Results:

• Fractional flow reserve (FFR) is the established standard for coronary physiologic assessment.
• Newer methods include pressure-wire-based non-hyperemic indices and wire-free quantitative flow ratio.
• Functional assessment reduces observer bias and improves clinical decision-making.

Conclusions:

• Physiologic assessment of multivessel coronary stenosis is crucial for accurate diagnosis and treatment.
• Utilizing functional evaluation improves patient outcomes and reduces major adverse cardiovascular events.
• This approach optimizes management strategies in the context of multivessel coronary artery disease.