Paradigm Shift to Functional Angioplasty

Ischemia-Guided Percutaneous Coronary Intervention for Patients With Stable Coronary Artery Disease

“…39, 40 FFR is unique and preferred for accurate assessment of the functional significance of stenosis of individual coronary arteries without the effect of hemodynamic conditions (eg, systemic pressure, heart rate, or contractile state). 41 Figure 2 shows an example of ischemia-guided PCI using FFR for the treatment of multivessel CAD. revascularization vs. medical therapy.…”

Mortality in Coronary Artery Bypass Grafting

“…16 Would short-term and long-term CABG mortality outcomes improve even further with a functional SYNTAXbased revascularization strategy? 17,18 Each of these questions highlights new, different, and important roles for mortality in CABG revascularization; some of these will be addressed in the National Heart, Lung, and Blood Institute's ISCHEMIA trial (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches), set to begin this summer. 19 RA long-term mortality models, as highlighted in the present New York State CSRS study, 13 emphasize the importance of assessing long-term outcomes after interventions for ischemic heart disease.…”

Prognostic Determinants of Coronary Atherosclerosis in Stable Ischemic Heart Disease

“…48 However, although MLA of >4 mm 2 in non-left main lesions predicted an FFR of >0.80 in 91% of cases, MLA of <4 mm 2 correlated poorly to FFR, with most studies reporting FFR of <0.8 in ≈50% of cases. [61][62][63] IVUS thresholds are also dependent on lesion location, 62,64 whereas the FFR threshold is not. The major reason why location strongly influences the IVUS/FFR relationship is that both the size of the reference vessel and the flow volume of the myocardial bed subtended by the stenotic vessel are important variables needed to compute the trans-stenotic pressure loss.…”