FFR检测操作及应用指导.ppt

* * * * This is the kind of pressure tracing that can be obtained. The first step is always to advance the pressure wire up to the tip of the catheter to be absolutely sure that the pressure are superimposed (verification + equalization). Then, the wire is advanced across the stenosis. FFRmyo is calculated from the mean signals from aortic pressure (Pa) and distal pressure (Pd), during maximum hyperemia. FFRmyo = Pd/Pa ? in this case 40 mmHg / 90 mm Hg = 0.44 * It is now possible to obtain this information by passing a pressure measuring guide wire (PressureWire) across a stenotic segment. The proximal pressure (Pa) is measured by the guiding catheter and the distal pressure (Pd) is measure by the PressureWire Sensor. The pressure sensor is located at the junction between the radiopaque and the non-radiopaque portion of the wire. * * * * Kom ih?g att ta ut n?len. * * By the definition of the FFRmyo, the measurement has to be done during maximum vasodilation. Maximum vasodilation can be achieved by a couple of different pharmacological drugs; Adenosine ATP – Adenosine Tri-Phosphate Papaverine * View of RCA before treatment. * As pointed out earlier, it is very important to verify 2 equal baseline pressures, from the guiding catheter and the PressureWire, before the procedure continue. This is done by placing the sensor of the Pressure Wire at the tip of the guiding catheter. The 2 pressures should be equal and superimposed. If they are not equal, the height of the pressure transducer (liquid transducer/Pa) has to be adjusted, or the equalize process has to be performed from the RADIAnalyzer/RADIAnalyzerXpress. * Here the Pressure Wire is distal to the target lesion and maximum hyperemia is induced, by intravenous infusion of adenosine. The pre PCI FFR in this case is 0.37, indicating clearly that the lesion is significant and treatment is needed. * The RCA has been stented proximal and the FFR is measured to verify the result. * When maximum hyperemia is induce