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Korean J Intern Med. 2013
;28(1):1-7.
DOI: 10.3904/kjim.2013.28.1.1
Physiologic approach for coronary intervention
William F. Fearon, M.D.
Division of Cardiovascular Medicine, Stanford University Medical Center, 300 Pasteur Drive, H2103, Stanford, CA 94305, USA |
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When invasively assessing coronary artery disease, the primary goal should be to determine whether the disease is causing a patient¡¯s symptoms and whether it is likely to cause future cardiac events. The presence of myocardial ischemia is our best gauge of whether a lesion is responsible for symptoms and likely to result in a future cardiac event. In the catheterization laboratory, fractional flow reserve (FFR) measured with a coronary pressure wire is the reference standard for identifying ischemia-producing lesions. Its spatial resolution is unsurpassed with it not only being vessel-specific, but also lesion-specific. There is now a wealth of data supporting the accuracy of measuring FFR to identify ischemia-producing lesions. FFR-guided percutaneous coronary intervention of these lesions results in improved outcomes and saves resources. Non-hemodynamically significant lesions can be safely managed medically with a low rate of subsequent cardiac events. |
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Keywords : Coronary disease; Coronary physiology |
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