Current Concepts of Integrated Coronary Physiology in the Catheterization Laboratory

Over the last 15 years, the use of invasive coronary physiology in the catheterization laboratory has demonstrated favorable outcomes for decision making in patients with intermediate single-vessel stenoses, complex bifurcation and ostial branch stenoses, multivessel coronary artery disease, and left main stenoses. A recent large multicenter study (FAME [FFR versus Angiography for Multivessel Evaluation]) found that a physiologically-guided approach was superior to the standard angiographically-guided approach for percutaneous revascularization in patients with multivessel coronary artery disease. This review addresses selected pertinent concepts and studies supporting the integration of coronary physiology in the catheterization laboratory for optimal patient outcomes.

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Posted in Invasive Imaging, Radiography and tagged , , , .

One Comment

  1. The authors describe how physiologic assessment of coronary lesions with hemodynamic significance has been integrated with anatomic coronary imaging in the catheterization laboratory. It is critical to consider these concepts in the assessment of coronary lesions with CTA.

    Also see:
    Comprehensive assessment of coronary artery stenoses: computed tomography coronary angiography versus conventional coronary angiography and correlation with fractional flow reserve in patients with stable angina.
    Meijboom WB, Van Mieghem CA, van Pelt N, Weustink A, Pugliese F, Mollet NR, Boersma E, Regar E, van Geuns RJ, de Jaegere PJ, Serruys PW, Krestin GP, de Feyter PJ.
    J Am Coll Cardiol. 2008 Aug 19;52(8):636-43.
    PMID: 18702967

    And post from 12/7/2009:
    Validation of Magnetic Resonance Myocardial Perfusion Imaging with Fractional Flow Reserve for the Detection of Significant Coronary Heart Disease.
    Watkins S, McGeoch R, Lyne J, Steedman T, Good R, McLaughlin MJ, Cunningham T, Bezlyak V, Ford I, Dargie HJ, Oldroyd KG
    Circulation. 2009; 120(22):2207-2213.
    PMID: 19917885

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