Discordance between pressure drift after wire pullback and intracoronary distal pressure offset affects stenosis physiology appraisal

Casadonte, Lorena; Piek, Jan J.; VanBavel, Ed; Spaan, Jos A. E.; Siebes, Maria

doi:10.1016/j.ijcard.2018.08.051

Cited by 3 publications

(4 citation statements)

References 36 publications

(56 reference statements)

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“…The pressure drift at the end of wire-based function tests is a non-negligible issue in physiology-guided coronary intervention because of its high incidence 4 , 7 , 9 , and the treatment strategy may require reclassification after repeated measurements 5 . To our knowledge, this is the first study to demonstrate that prolonging pressure equalization at the initiation of an invasive coronary function test may lower the incidence of significant pressure drift at the end of the procedure.…”

Section: Discussionmentioning

confidence: 99%

“…However, if the gradient exceeds 2-3 mmHg, it is considered a significant drift 3,5 . In this case, repeated pressure equalization and function testing should be performed to obtain an accurate measurement.The prevalence of significant drift ranges from 7.4 to 73% for piezoelectric sensors 4,[6][7][8][9] . This large variation may be due to the differences in vendor pressure wires, the definitions of significant drifts, and operator-dependent errors.…”

mentioning

confidence: 99%

“…The prevalence of significant drift ranges from 7.4 to 73% for piezoelectric sensors 4,[6][7][8][9] . This large variation may be due to the differences in vendor pressure wires, the definitions of significant drifts, and operator-dependent errors.…”

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confidence: 99%

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Effect of prolonged pressure equalization on final drifting during pressure wire studies

Jong,

Lu,

Lin

et al. 2024

Sci Rep

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Pressure drifting is a troublesome error in invasive coronary function tests. This study aimed to evaluate the relationship between prolonged and short-time pressure equalizations in pressure drifting. Pressure drifting was defined as the pressure gradient between the mean pressure of the distal wire sensor (Pd) and aortic pressure (Pa) when the wire was withdrawn to the tip of the guiding catheter. Significant drifts 1 and 2 were defined as the absolute values of pressure gradients > 2 and > 3 mmHg, respectively. A logistic regression model was used to evaluate the associations between prolonged pressure equalization and each pressure drifting. The prolonged pressure equalization strategy was associated with a lower incidence of drift 1 than the short-time pressure equalization strategy (6.84% vs. 16.92%, p < 0.05). However, no statistical differences were found in the incidence of drift 2 between the prolonged and short-time pressure equalization strategies (4.27% vs. 7.69%, p = 0.34). In the multivariable regression model, only the prolonged pressure equalization strategy predicted a lower incidence of pressure drift 1. In conclusion, the prolonged pressure equalization strategy was associated with a lower incidence of significant pressure drifting with more stringent thresholds than the short-time pressure equalization strategy.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Effect of prolonged pressure equalization on final drifting during pressure wire studies

Jong,

Lu,

Lin

et al. 2024

Sci Rep

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“…Fluid-filled sensors display a dynamic range that can result in an overestimation of pressures [22], measurements that are subject to damping and resonance, and a reduced frequency response which inherently impacts temporal resolution [9,23,24]. Pressure wires have successfully been used for transaortic pressure drop measurement; however, the technology remains susceptible to difficulty with positioning and may also suffer drift causing uncertainty in the accuracy of measured values [25][26][27]. Our solution was direct pressure transduction from sensors in the phantom wall which were calibrated and validated against a gold-standard solidstate catheter.…”

Section: Sensing the Pressure Dropsmentioning

confidence: 99%

Aortic Stenosis: Haemodynamic Benchmark and Metric Reliability Study

Gill

Fernandes

Nio

et al. 2023

J. of Cardiovasc. Trans. Res.

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Aortic stenosis is a condition which is fatal if left untreated. Novel quantitative imaging techniques which better characterise transvalvular pressure drops are being developed but require refinement and validation. A customisable and cost-effective workbench valve phantom circuit capable of replicating valve mechanics and pathology was created. The reproducibility and relationship of differing haemodynamic metrics were assessed from ground truth pressure data alongside imaging compatibility. The phantom met the requirements to capture ground truth pressure data alongside ultrasound and magnetic resonance image compatibility. The reproducibility was successfully tested. The robustness of three different pressure drop metrics was assessed: whilst the peak and net pressure drops provide a robust assessment of the stenotic burden in our phantom, the peak-to-peak pressure drop is a metric that is confounded by non-valvular factors such as wave reflection. The peak-to-peak pressure drop is a metric that should be reconsidered in clinical practice. Graphical abstract The left panel shows manufacture of low cost, functional valves. The central section demonstrates circuit layout, representative MRI and US images alongside gross valve morphologies. The right panel shows the different pressure drop metrics that were assessed for reproducibility

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Reference values for intracoronary Doppler flow velocity-derived hyperaemic microvascular resistance index

Feenstra¹,

Seitz²,

Boerhout³

et al. 2023

International Journal of Cardiology

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Discordance between pressure drift after wire pullback and intracoronary distal pressure offset affects stenosis physiology appraisal

Abstract: Post-procedural pressure drift frequently does not match drift during physiological assessment. Tracing-specific correction for intra-procedural drift can potentially lower the risk of inadvertent diagnostic misclassification and prevent unnecessary repeats.

Cited by 3 publications

References 36 publications

Effect of prolonged pressure equalization on final drifting during pressure wire studies

Effect of prolonged pressure equalization on final drifting during pressure wire studies

Aortic Stenosis: Haemodynamic Benchmark and Metric Reliability Study

Reference values for intracoronary Doppler flow velocity-derived hyperaemic microvascular resistance index

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