1995
DOI: 10.1016/0735-1097(95)80003-y View full text |Buy / Rent full text
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Abstract: 1) In an unselected patient cohort, geometric indexes of stenosis severity derived from quantitative coronary angiography correlate significantly with physiologic variables, although these relations are imprecise in individual patients. 2) Nevertheless, the diagnostic accuracy of quantitative coronary angiography in predicting myocardial fractional flow reserve < 0.72 is high and allows its use for clinical decision making in the individual patient during diagnostic or interventional procedures.

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“…The wire was introduced through either a 6F or 7F guiding catheter, calibrated, advanced into the coronary artery, and, after equalization, positioned distal to the stenosis as previously described. 26,27 Adenosine was administered to induce maximum hyperemia using either (1) intravenous adenosine at 140 g/kg per minute infusion or (2) intracoronary adenosine (using a 50-g bolus in most cases). In some cases (ie, FFR values close to 0.80), we used incremental doses of IC adenosine up to 150 g, provided the patient tolerated the lower dose, to ensure that maximum hyperemia was achieved.…”
Section: Pressure Measurementsmentioning
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“…The wire was introduced through either a 6F or 7F guiding catheter, calibrated, advanced into the coronary artery, and, after equalization, positioned distal to the stenosis as previously described. 26,27 Adenosine was administered to induce maximum hyperemia using either (1) intravenous adenosine at 140 g/kg per minute infusion or (2) intracoronary adenosine (using a 50-g bolus in most cases). In some cases (ie, FFR values close to 0.80), we used incremental doses of IC adenosine up to 150 g, provided the patient tolerated the lower dose, to ensure that maximum hyperemia was achieved.…”
Section: Pressure Measurementsmentioning
“…1,2 FFR has been shown to be valid in patients with stable angina pectoris under widely varying hemodynamic conditions 3,4 and to be clinically useful for diagnostic and interventional purposes. [5][6][7][8][9][10][11][12][13][14] In humans, however, coronary atherosclerosis is diffuse, and coronary arteriograms frequently demonstrate several consecutive stenoses along the same epicardial artery, the severities of which need to be determined separately. In case of 2 consecutive stenoses, the fluid dynamic interaction between the stenoses alters their relative severity and complicates determination of FFR for each stenosis separately from the simple ratio of P d /P a for a single stenosis.…”
mentioning
“…Coronary anatomy, however, may not allow to estimate with certainty the pathophysiologic relevance of a coronary lesion, as particularly in intermediate lesions there are many factors influencing the interrelation between anatomic finding and hemodynamic consequences which can not be fully elucidated by anatomic evaluation alone, not even with the use of quantitative coronary angiograpy (17). Therefore, according to the actual European and American guidelines a test for ischemia before any elective coronary angiography is mandatory (18)(19)(20).…”
Section: Coronary Stenoses and Ischemic Heart Disease: Two Faces Of Tmentioning