Optimizing Coronary Angioplasty with FFR and Intravascular Imaging

AbstractPurpose of ReviewPercutaneous coronary intervention has changed the approach to coronary artery disease management, but angiography remains the principal method for determining the severity of disease. Because an angiogram only identifies the outline of the lumen, angiography is not the most sensitive or accurate instrument. This leads to significant inter-observer variation in interpretation of intermediate lesions. Additional technologies have been developed to better evaluate the extent of disease and identify potential high risk lesions. This paper reviews the strengths and deficits of these techniques.Recent FindingsClinical outcomes data validate the use of fractional flow reserve (FFR) for physiologic assessment of coronary artery stenosis. Intravascular imaging technology provides unique anatomic information about atherosclerotic plaque. Optical coherence tomography (OCT) has high resolution for visualizing stents and inner-lumen anatomy such as dissections. Intravascular ultrasound (IVUS) has less spatial resolution but has greater penetrating power and therefore provides a more complete picture of atherosclerotic plaque. VH has not been adequately validated and can be misleading compared with tissue histology. NIRS is an emerging technology and, while promising, has not yet achieved widespread application.SummaryInvasive evaluation is an essential part of coronary artery disease assessment. Some of the techniques in use such as FFR have shown correlation wit...
Source: Current Cardiovascular Risk Reports - Category: Cardiology Source Type: research