Open full size image Background and Limitations of Angiography Contrast angiography has been the gold standard of coronary artery imaging for over six decades. However, it is important to understand that angiograms only delineate the coronary lumen with no direct…
Open full size image Introduction Coronary blood flow and pressure measurements across a stenotic coronary artery provide information on the ischemic potential of a specific lesion at the time of catheterization. Physiologic assessment of coronary artery stenosis by fractional flow…
Open full size image Introduction Acute myocardial infarction is caused by thrombotic occlusion of a native coronary artery. While partial occlusion usually presents as a non ST-elevation myocardial infarction (NSTEMI), it is expected that complete occlusion will result in ST-elevation…
Open full size image Introduction The development of percutaneous coronary intervention (PCI) with stent implantation has revolutionized the practice of cardiology over the course of the past decades. However, despite considerable technological advancements, in-stent restenosis (ISR) remains the most common…
Open full size image Introduction Calcified coronary lesions present an important challenge to interventional cardiologists. Because of the rigidity and noncompliance of a heavily calcified coronary artery segment, heavy calcification was a risk factor for traditional balloon angioplasty failure and…
Open full size image Dr. Brilakis: Research support from the Department of Veterans Affairs (PI of the Drug Eluting Stents in Saphenous Vein Graft Angioplasty—DIVA trial and Merit grant—I01-CX000787-01) and from the National Institutes of Health (1R01HL102442-01A1); consulting fees/speaker honoraria…
Open full size image Introduction A bifurcation coronary lesion is a stenosis involving or adjacent to the origin of an arterial side branch ≥2 mm in diameter. The stenosis can involve the large branch (main branch, MB), the smaller branch (side…
Open full size image Introduction Despite remarkable advances in the procedural and clinical outcomes of percutaneous revascularization, chronically occluded coronary arteries represent persistent technical challenges and unresolved clinical dilemmas in interventional cardiology. Although a coronary chronic total occlusion (CTO) is…
Open full size image Philippe Généreux has received speaker fees from Abbott Vascular and is a consultant for Cardiovascular System, Inc. Introduction Left main (LM) coronary artery disease, defined by a visually estimated diameter stenosis of at least 50%, is…
Open full size image Introduction Iodinated contrast media (CM) are widely used in interventional cardiology. Efficacy is predicated on the capacity to opacify intravascular structures; however, when selecting a CM, other important properties should be considered. Most notably, chemical properties…