Review Article2021 Feb, 14 (3) 237–246
JOURNAL:JACC: Cardiovascular Interventions Article Link
Invasive Coronary Physiology After Stent Implantation: Another Step Toward Precision Medicine
S Biscaglia , B Uretsky , E Barbato , C Collet et al.
Keywords:
intracoronary physiology; post PCI; functional assessment
ABSTRACT
Intracoronary physiology is routinely used in setting the indication for
percutaneous coronary intervention (PCI) but seldom in assessing
procedural results. This attitude is increasingly challenged by
accumulated evidence demonstrating the value of post-PCI functional
assessment in predicting long-term patient outcomes. Besides fractional
flow reserve, a number of new indexes recently incorporated to clinical
practice, including nonhyperemic pressure and functional angiographic
indexes, provide new opportunities for the physiological assessment of
PCI results. Largely, the benefit of these tools is derived from
longitudinal analysis of the treated vessel, which allows precise
identification of the vessel segment accounting for a suboptimal
functional result and enabling operators to perform accurate PCI
optimization. In this document the authors review available evidence
supporting why physiological assessment should be extended to immediate
post-PCI with the aim of improving patient outcomes. A step-by-step
guide on how available physiological tools can be used for such purpose
is provided.