The role of coronary physiology in contemporary percutaneous coronary interventions.

Author:

Marin Federico1ORCID,Scarsini Roberto1,Terentes-Printzios Dimitrios2ORCID,Kotronias Rafail A.2,Ribichini Flavio1,Banning Adrian P.2ORCID,De Maria Giovanni Luigi2ORCID

Affiliation:

1. Division of Cardiology, University of Verona, Verona , Italy

2. Oxford Heart Centre, Oxford University Hospitals, Oxford , United Kingdom

Abstract

: Invasive assessment of coronary physiology has radically changed the paradigm of myocardial revascularization in patients with coronary artery disease. Despite the prognostic improvement associated with ischemia-driven revascularization strategy, functional assessment of angiographic intermediate epicardial stenosis remains largely underused in clinical practice. Multiple tools have been developed or are under development in order to reduce the invasiveness, cost, and extra procedural time associated with the invasive assessment of coronary physiology. Besides epicardial stenosis, a growing body of evidence highlights the role of coronary microcirculation in regulating coronary flow with consequent pathophysiological and clinical and prognostic implications. Adequate assessment of coronary microcirculation function and integrity has then become another component of the decision-making algorithm for optimal diagnosis and treatment of coronary syndromes. This review aims at providing a comprehensive description of tools and techniques currently available in the catheterization laboratory to obtain a thorough and complete functional assessment of the entire coronary tree (both for the epicardial and microvascular compartments).

Publisher

Bentham Science Publishers Ltd.

Subject

Cardiology and Cardiovascular Medicine,General Medicine

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