Nijjer Sukhjinder S, Sen Sayan, Petraco Ricardo, Mayet Jamil, Francis Darrel P, Davies Justin E R
Imperial College London, London, UK.
Imperial College London, London, UK.
Cardiovasc Revasc Med. 2015 Apr-May;16(3):167-71. doi: 10.1016/j.carrev.2015.01.006. Epub 2015 Jan 29.
Coronary intervention is increasingly performed in complex disease with tandem and diffuse disease. Pressure wires enable detailed assessment of the physiological significance of a stenosis but in the presence of tandem disease, predicting the impact of a stenting a given stenosis can be difficult and is impeded by flow interaction between stenoses under hyperemia. In this review, we consider the physiological difficulties posed by flow interaction under hyperemia and consider alternative approaches such as assessment under baseline conditions. Specifically we consider the potential value of the iFR-Pullback approach and its capacity to enable Virtual-PCI, which may assist in planning intervention.
冠状动脉介入治疗越来越多地应用于合并串联病变和弥漫性病变的复杂疾病。压力导丝能够详细评估狭窄的生理意义，但在存在串联病变的情况下，预测对给定狭窄进行支架置入的影响可能很困难，并且会受到充血状态下狭窄之间血流相互作用的阻碍。在本综述中，我们考虑了充血状态下血流相互作用所带来的生理难题，并探讨了诸如在基线条件下进行评估等替代方法。具体而言，我们考虑了iFR回撤法的潜在价值及其实现虚拟PCI的能力，这可能有助于干预计划的制定。
