By Tommaso Gori, Massimo Fineschi
This e-book reports the speculation and perform of fractional move reserve (FFR)-guided coronary intervention, a strategy that provides experience and a purpose to day-by-day judgements within the interventional suite. FFR information presents certain details on coronary hemodynamics for the interventional heart specialist. this system has profound useful implications for healing judgements and for the diagnosis of sufferers.
The Atlas of FFR-Guided Percutaneous Coronary Interventions offers practising physicians transparent info to appreciate either the complexity of the strategy and the right kind solution to follow it. it truly is designed either to help more youthful school and people in education, and to behave as a medical source for more matured practitioners. utilizing the medical instances defined, the reader can learn how to have fun with the pitfalls, counsel and tips that simplify the functionality and interpretation of FFR and iFR.
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Additional info for Atlas of FFR-Guided Percutaneous Coronary Interventions
In analogy, even in vessels with a focal lesion treated successfully, a residual hyperemic gradient may remain between catheter and distal vessel. After stenting, it is therefore always important to assess the Pd/Pa gradient across the whole vessel and across the stented segment. The first provides a surrogate index of overall atherosclerotic burden, while the latter informs about the successfulness of the intervention. Of note, a 37 recent patient-level metaanalysis confirmed that, analogous to FFR prior to intervention, FFR measured after PCI is inversely associated with subsequent events [3, 4].
55 the true lumen). In the editor’s experience, FFR can be measured with 6F but not 4F catheters without altering the results. Other authors have also reported good accuracy with 4F catheters . This case demonstrates the repeatability of FFR measurements obtained using different methods and in different hemodynamic conditions . Final Comments References Assessment of FFR with a diagnostic catheter is possible but not very reasonable. Measuring pressure-derived fractional flow reserve through four the catheterization laboratory when FFR is negative, it actuFrench diagnostic catheters.
This gradient is, however, due to the dumping of the Pa (red) rather than a normalization of the Pd (green) one. Whatever the initial FFR is, this curve does not allow a reliable investigation of coronary hemodynamics. Particularly when intracoronary adenosine is used, particular attention must be taken to make sure that the catheter is not obstructive. Pa must at all times represent aortic pressure. Tonino PA, De Bruyne B, Pijls NH, Siebert U, Ikeno F. van’ t Veer M, et al. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention.
Atlas of FFR-Guided Percutaneous Coronary Interventions by Tommaso Gori, Massimo Fineschi