Part XII: Assessment of serial lesions in the proximal right coronary artery following intracoronary thrombolysis.

Assessment of angiographically serial coronary lesions at the time of diagnostic catheterization remains a difficult clinical problem. Doppler flow velocity data is easily obtainable and allows physiologic interrogation of the distal coronary microcirculation, but has limitations in the detection of some flow-limiting stenoses. In cases of serial lesions or distal arterial disease, particularly after thrombolysis, flow velocity data may be insufficient to identify the hemodynamic significance of the coronary lesions. Translesional pressure measurements may be combined with flow velocity data to support an appropriate physiologically based therapeutic approach.