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Active factor XI is associated with the risk of cardiovascular events in stable coronary artery disease patients Long-Term Outcomes of Different Two-Stent Techniques With Second-Generation Drug-Eluting Stents for Unprotected Left Main Bifurcation Disease: Insights From the FAILS-2 Study Machine Learning Using CT-FFR Predicts Proximal Atherosclerotic Plaque Formation Associated With LAD Myocardial Bridging Angiographic versus functional severity of coronary artery stenoses in the FAME study fractional flow reserve versus angiography in multivessel evaluation EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion – an update Left main coronary angioplasty: early and late results of 127 acute and elective procedures New Evidence Supporting a Novel Conceptual Framework for Distinguishing Proportionate and Disproportionate Functional Mitral Regurgitation Comparative efficacy of two paclitaxel-coated balloons with different excipient coatings in patients with coronary in-stent restenosis: A pooled analysis of the Intracoronary Stenting and Angiographic Results: Optimizing Treatment of Drug Eluting Stent In-Stent Restenosis 3 and 4 trials Contemporary prevalence of pulmonary arterial hypertension in adult congenital heart disease following the updated clinical classification Long-term safety and effectiveness of unprotected left main coronary stenting with drug-eluting stents compared with bare-metal stents

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.