Fractional flow reserve and non-hyperemic indices: Essential tools for percutaneous coronary interventions

Boutaleb, A.; Ghafari, Chadi; Carlier, Stéphane

doi:10.12998/wjcc.v11.i10.2123

Cited by 6 publications

(2 citation statements)

References 91 publications

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“…When clinically indicated ( n = 20), fractional flow reserve was measured using a 0.014” wire including, at its tip, a high fidelity electronic pressure transducer (Comet wire, Boston Scientific, Marlborough, MA, USA) after additional Heparin (2500 U) was administered intravenously [ 30 ].…”

Section: Methodsmentioning

confidence: 99%

High Fidelity Pressure Wires Provide Accurate Validation of Non-Invasive Central Blood Pressure and Pulse Wave Velocity Measurements

et al. 2023

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Central blood pressure (cBP) is known to be a better predictor of the damage caused by hypertension in comparison with peripheral blood pressure. During cardiac catheterization, we measured cBP in the ascending aorta with a fluid-filled guiding catheter (FF) in 75 patients and with a high-fidelity micromanometer tipped wire (FFR) in 20 patients. The wire was withdrawn into the brachial artery and aorto-brachial pulse wave velocity (abPWV) was calculated from the length of the pullback and the time delay between the ascending aorta and the brachial artery pulse waves by gating to the R-wave of the ECG for both measurements. In 23 patients, a cuff was inflated around the calf and an aorta-tibial pulse wave velocity (atPWV) was calculated from the distance between the cuff around the leg and the axillary notch and the time delay between the ascending aorta and the tibial pulse waves. Brachial BP was measured non-invasively and cBP was estimated using a new suprasystolic oscillometric technology. The mean differences between invasively measured cBP by FFR and non-invasive estimation were −0.4 ± 5.7 mmHg and by FF 5.4 ± 9.4 mmHg in 52 patients. Diastolic and mean cBP were both overestimated by oscillometry, with mean differences of −8.9 ± 5.5 mmHg and −6.4 ± 5.1 mmHg compared with the FFR and −10.6 ± 6.3 mmHg and −5.9 ± 6.2 mmHg with the FF. Non-invasive systolic cBP compared accurately with the high-fidelity FFR measurements, demonstrating a low bias (≤5 mmHg) and high precision (SD ≤ 8 mmHg). These criteria were not met when using the FF measurements. Invasively derived average Ao-brachial abPWV was 7.0 ± 1.4 m/s and that of Ao-tibial atPWV was 9.1 ± 1.8 m/s. Non-invasively estimated PWV based on the reflected wave transit time did not correlate with abPWV or with atPWV. In conclusion, we demonstrate the advantages of a novel method of validation for non-invasive cBP monitoring devices using acknowledged gold standard FFR wire transducers and the possibility to easily measure PWV during coronary angiography with the impact of cardiovascular risk factors.

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Section: Methodsmentioning

confidence: 99%

High Fidelity Pressure Wires Provide Accurate Validation of Non-Invasive Central Blood Pressure and Pulse Wave Velocity Measurements

et al. 2023

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“…The two invasive functional tests guiding the first functional assessment of coronary stenoses are iFR and FFR (Table 1). FFR is defined as the pressure distal to a stenosis relative to the pressure before the stenosis (10). An FFR value of < 0.8 indicates a functionally severe stenosis.…”

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confidence: 99%

The role of coronary physiology in the management of percutaneous coronary intervention: Insights from the European Association of Percutaneous Cardiovascular Interventions (EAPCI) Consensus

Mafricaa,

Spadafora,

Galanti

et al. 2023

HVT

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The European Association of Percutaneous Cardiovascular Interventions (EAPCI) recently released a consensus statement on coronary physiology's role in managing percutaneous coronary interventions (PCI). Indeed, in recent years, significant advancements have been made in coronary imaging techniques, which have greatly improved our ability to assess stenosis features. Techniques like instantaneous wave-free ratio (iFR), fractional flow reserve (FFR), and longitudinal vessel analysis have evolved, providing insights into the hemodynamic significance of coronary lesions and guiding treatment decisions, particularly in PCI. This commentary aims to enlighten the critical issues of the EAPCI statement, briefly reviewing the main techniques for the study of coronary physiology and their applications.

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Shaping the Future of Cardiovascular Disease by 3D Printing Applications in Stent Technology and its Clinical Outcomes

Ullah,

Bibi,

Wahab

et al. 2024

Current Problems in Cardiology

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Fractional flow reserve and non-hyperemic indices: Essential tools for percutaneous coronary interventions

Cited by 6 publications

References 91 publications

High Fidelity Pressure Wires Provide Accurate Validation of Non-Invasive Central Blood Pressure and Pulse Wave Velocity Measurements

High Fidelity Pressure Wires Provide Accurate Validation of Non-Invasive Central Blood Pressure and Pulse Wave Velocity Measurements

The role of coronary physiology in the management of percutaneous coronary intervention: Insights from the European Association of Percutaneous Cardiovascular Interventions (EAPCI) Consensus

Shaping the Future of Cardiovascular Disease by 3D Printing Applications in Stent Technology and its Clinical Outcomes

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