FFR检测操作和应用指导.ppt

* * Notes: * * Notes: * * Notes: * * Notes: * * Notes: TVR Target vessel revascularization * * The STENT Registry is a multicenter registry including 750 patients from 15 hospitals in 8 countries. The conclusion from the analysis of these patients was that FFR after stenting is a strong independent predictor of outcome at 6 months. The predictive value of FFR is independent of any other baseline or procedural parameter and is present for both death and AMI and for repeated TVR. Using a pressure pull-back curve helped to determine if the gradient after stenting is due to: - incomplete stent deployment;  - abnormalities within or adjacent;  - disease more proximal. * * Notes: * * * * * * * * * * * * * * 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 Pr