培训课件--FFR基本概念和临床应用.ppt

* Notes: * Notes: * Notes: * Notes: * Notes: * Notes: * After stent 3.5 mm (mid-RCA) FFR = 0.80 Not optimal post stent result FFR Case Stent 3.5 mm (mid-RCA) + Stent 3.5 mm (prox-RCA) FFR = 0.94 Optimal post stent result FFR Case FFR 正常值=1，0.75-0.80灰色地带，FFR0.75,特异度100%； FFR不受血流动力学的影响（心率、血压等）； FFR解释了心外膜下血管的狭窄病变对远端心肌灌注血流的影响； FFR考虑了侧枝循环； FFR非常容易测量和有非常好的重复性； 通过PULL BACK方式，能对血管进行整体评估。 小结 FFR可以给介入医生的在制定患者治疗策略时提供更多信息和依据， 因为： 血管造影术本身的局限性 形态学和功能学的差异 无创评估指标的局限性 不加选择的使用DES的潜在不利因素 小结 谢 谢！ * * * * * * * * * Notes: * The slides in this presentation are intended to illustrate the following: Defining the significance of a given CSA (lumen cross sectional area) by IVUS is dependant on the normal size of the artery which varies considerably from one artery to another and from one person to another. FFR is a relative index that takes into account the size of the person and the size of the vessel. Physiologic stenosis severity cannot be judged without taking into account the perfusion area.IVUS is only a picture of the vessel and does not tell us about the needs of the perfusion area supplied by the vessel. FFR is a relative index that takes into account size of perfusion area. - Collaterals modify physiologic stenosis severity. IVUS does not tell us how much collaterals contribute to supplying the myocardium. FFR is a relative index that takes into account collateral function. - An increase or decrease in the severity of one lesion will modify the physiologic stenosis severity of other lesions in series. IVUS is only a picture, and the picture of one stenosis will not change if another stenosis in the same vessel is stented. FFR for an entire vessel may very well change before and after stenting of one stenosis in series because in a series, one stenosis affects another. - In the case of a long, diffuse lesion, IVUS may find no area with a significant CSA, however FFR will show evidence of ischemis, because long lesions are often more hemodynamically sig