ffr血流储备分数精编版课件.ppt

* It could be very difficult to predict the severity of an intermediate stenosis (40-60%) just by eyeballing an fluoroscopic image. Does this RCA stenosis look significant? Should it be treated?According to the FFR measurement this lesion is NOT significant and is NOT the lesion that causes the patients chest pain/ischemia. Reference: “How good are experienced cardiologists at predicting the hemodynamic severity of coronary stenoses when taking FFR as the golden standard”, Brueren et al, The international Journal of Cardiovascular Imaging; 2002: 18; 73-76 * In arteries with serial stenoses it is helpful to perform a “pullback” over the stenoses to find the culprit lesion(-s) causing the patient’s ischemia. In this case the vessel has serial lesions that look quite severe. By performing a pullback you find out that there is no pressure drop at the 2nd or 3rd stenosis. The 1st and 4th are the culprit lesions. * In a vessel with diffuse disease the pullback shows that there is no culprit lesion that is the cause of the patients symptoms. PressureWire? curve is linear. * In the case of a main stem stenosis, it can be helpful to measure pressure. Physiological assessment of the left main could mean the difference between Coronary Artery Bypass (CABG), PCI only, or no treatment required at all. * The conclusion of the study by Koo was that most side branch lesions suspect after stenting of the main branch are actually NOT functionally significant. Of 73 lesions (with greater than 74% stenosis), only 20 were functionally significant.Amongst relatively large side branches( with greater than 74% stenosis by QCA), and usually considered the target for side branch intervention, only 38% were functionally significant - looks can be deceiving. * Notes: * Notes: * Notes: * Notes: * Notes: * Notes: * Notes: * Notes: * Notes: * * * * It is now possible to obtain this information by passing a pressure measuring guide wire (PressureWire) across a stenotic segment. The pr