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Exercise Intolerance in Patients With Heart Failure: JACC State-of-the-Art Review Accuracy of Fractional Flow Reserve Derived From Coronary Angiography A Combined Optical Coherence Tomography and Intravascular Ultrasound Study on Plaque Rupture, Plaque Erosion, and Calcified Nodule in Patients With ST-Segment Elevation Myocardial Infarction: Incidence, Morphologic Characteristics, and Outcomes After Percutaneous Coronary Intervention Intravascular ultrasound guidance improves clinical outcomes during implantation of both first- and second-generation drug-eluting stents: a meta-analysis A Randomized Controlled Trial to Evaluate the Safety and Efficacy of Cardiac Contractility Modulation Intravascular Ultrasound Assessment of In-Stent Restenosis in Saphenous Vein Grafts Intravascular ultrasound-guided drug-eluting stent implantation: An updated meta-analysis of randomized control trials and observational studies Is intravascular ultrasound beneficial for percutaneous coronary intervention of bifurcation lesions? Evidence from a 4,314-patient registry Lifestyle Modifications for Preventing and Treating Heart Failure Transcatheter Mitral Valve Replacement in Patients with Heart Failure and Secondary Mitral Regurgitation: From COAPT Trial

Review Article2021 Feb, 14 (3) 237–246

JOURNAL:JACC: Cardiovascular Interventions Article Link

Invasive Coronary Physiology After Stent Implantation: Another Step Toward Precision Medicine

S Biscaglia , B Uretsky , E Barbato , C Collet et al. Keywords: intracoronary physiology; post PCI; functional assessment

ABSTRACT

Intracoronary physiology is routinely used in setting the indication for percutaneous coronary intervention (PCI) but seldom in assessing procedural results. This attitude is increasingly challenged by accumulated evidence demonstrating the value of post-PCI functional assessment in predicting long-term patient outcomes. Besides fractional flow reserve, a number of new indexes recently incorporated to clinical practice, including nonhyperemic pressure and functional angiographic indexes, provide new opportunities for the physiological assessment of PCI results. Largely, the benefit of these tools is derived from longitudinal analysis of the treated vessel, which allows precise identification of the vessel segment accounting for a suboptimal functional result and enabling operators to perform accurate PCI optimization. In this document the authors review available evidence supporting why physiological assessment should be extended to immediate post-PCI with the aim of improving patient outcomes. A step-by-step guide on how available physiological tools can be used for such purpose is provided.