Key Points Angiography alone is often insufficient to assess intermediate and, at times, severe stenoses. Although adjunctive stress testing has limitations, fractional flow reserve (FFR) provides an accurate detector of lesion specific myocardial ischemia. Deferring revascularization of a coronary stenosis…
Key points Angiographic determination of the significance for a given coronary lesion remains limited. Numerous physiologic indexes are now available that rely on coronary hyperemia (fractional flow reserve [FFR]) and nonhyperemic indexes [aka NHPR] (e.g., instantaneous wave-free pressure ratio [iFR],…
Key points Anticoagulant and antiplatelet medications are required for the safe percutaneous coronary intervention (PCI). Recent studies have demonstrated that shorter durations of dual antiplatelet therapy (DAPT) are safe. Vasodilators and vasopressors may often be necessary in some complicated or…
Key points Percutaneous coronary intervention (PCI) procedures in today’s cath lab require assimilating numerous details regarding a patient’s clinical history, testing before catheterization with anatomic information provided from the diagnostic angiogram. PCI requires an understanding of anticoagulation therapy, guide catheters,…
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…
Acknowledgment This section extends the corresponding chapter of prior editions of Braunwald’s Heart Disease , which was authored by Drs. Charles J. Davidson and Robert O. Bonow. Additional content is available online at Elsevier eBooks for Practicing Clinicians Introduction to…