Physiology-Based Revascularization: A New Approach to Plan and Optimize Percutaneous Coronary Interventionopen access
- Authors
- Lee, J.M.[Lee, J.M.]; Lee, S.H.[Lee, S.H.]; Shin, D.[Shin, D.]; Choi, K.H.[Choi, K.H.]; van, de Hoef T.P.[van, de Hoef T.P.]; Kim, H.K.[Kim, H.K.]; Samady, H.[Samady, H.]; Kakuta, T.[Kakuta, T.]; Matsuo, H.[Matsuo, H.]; Koo, B.-K.[Koo, B.-K.]; Fearon, W.F.[Fearon, W.F.]; Escaned, J.[Escaned, J.]
- Issue Date
- Jun-2021
- Publisher
- Elsevier Inc.
- Keywords
- fractional flow reserve; instantaneous wave-free ratio; nonhyperemic pressure ratios; percutaneous coronary intervention; prognosis
- Citation
- JACC: Asia, v.1, no.1, pp.14 - 36
- Indexed
- SCOPUS
- Journal Title
- JACC: Asia
- Volume
- 1
- Number
- 1
- Start Page
- 14
- End Page
- 36
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/99443
- DOI
- 10.1016/j.jacasi.2021.03.002
- ISSN
- 2772-3747
- Abstract
- Coronary physiological assessment using fractional flow reserve or nonhyperemic pressure ratios has become a standard of care for patients with coronary atherosclerotic disease. However, most evidence has focused on the pre-interventional use of physiological assessment to aid revascularization decision-making, whereas post-interventional physiological assessment has not been well established. Although evidence for supporting the role of post-interventional physiological assessment to optimize immediate revascularization results and long-term prognosis has been reported, a more thorough understanding of these data is crucial in incorporating post-interventional physiological assessment into daily practice. Recent scientific efforts have also focused on the potential role of pre-interventional fractional flow reserve or nonhyperemic pressure ratio pullback tracings to characterize patterns of coronary atherosclerotic disease to better predict post-interventional physiological outcomes, and thereby identify the appropriate revascularization target. Pre-interventional pullback tracings with dedicated post-processing methods can provide characterization of focal versus diffuse disease or major gradient versus minor gradient stenosis, which would result in different post-interventional physiological results. This review provides a comprehensive look at the current evidence regarding the evolving role of physiological assessment as a functional optimization tool for the entire process of revascularization, and not merely as a pre-interventional tool for revascularization decision-making. © 2021 The Authors
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Collections - Medicine > Department of Medicine > 1. Journal Articles
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