TY - JOUR
T1 - Applied coronary physiology for planning and guidance of percutaneous coronary interventions. A clinical consensus statement from the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the European Society of Cardiology
AU - Escaned, Javier
AU - Berry, Colin
AU - de Bruyne, Bernard
AU - Shabbir, Asad
AU - Collet, Carlos
AU - Lee, Joo Myung
AU - Appelman, Yolande
AU - Barbato, Emanuele
AU - Biscaglia, Simone
AU - Buszman, Piotr P.
AU - Campo, Gianluca
AU - Chieffo, Alaide
AU - Jeremias, Allen
AU - Paradies, Valeria
AU - Piróth, Zsolt
AU - Raposo, Luís
AU - Roguin, Ariel
AU - Rudolph, Tanja
AU - Sarno, Giovanna
AU - Sen, Sayan
AU - Toth, Gabor G.
AU - van Belle, Eric
AU - Zimmermann, Frederick M.
AU - Dudek, Dariusz
AU - Stefanini, Giulio
AU - Tarantini, Giuseppe
N1 - Funding Information: We are indebted to Silvio Capuano for their technical support in preparing the supplementary tables for this document. Publisher Copyright: © Europa Digital & Publishing 2023. All rights reserved.
PY - 2023/8/21
Y1 - 2023/8/21
N2 - The clinical value of fractional flow reserve and non-hyperaemic pressure ratios are well established in determining an indication for percutaneous coronary intervention (PCI) in patients with coronary artery disease (CAD). In addition, over the last 5 years we have witnessed a shift towards the use of physiology to enhance procedural planning, assess post-PCI functional results, and guide PCI optimisation. In this regard, clinical studies have reported compelling data supporting the use of longitudinal vessel analysis, obtained with pressure guidewire pullbacks, to better understand how obstructive CAD contributes to myocardial ischaemia, to establish the likelihood of functionally successful PCI, to identify the presence and location of residual flow-limiting stenoses and to predict long-term outcomes. The introduction of new functional coronary angiography tools, which merge angiographic information with fluid dynamic equations to deliver information equivalent to intracoronary pressure measurements, are now available and potentially also applicable to these endeavours. Furthermore, the ability of longitudinal vessel analysis to predict the functional results of stenting has played an integral role in the evolving field of simulated PCI. Nevertheless, it is important to have an awareness of the value and challenges of physiology-guided PCI in specific clinical and anatomical contexts. The main aim of this European Association of Percutaneous Cardiovascular Interventions clinical consensus statement is to offer up-to-date evidence and expert opinion on the use of applied coronary physiology for procedural PCI planning, disease pattern recognition and post-PCI optimisation.
AB - The clinical value of fractional flow reserve and non-hyperaemic pressure ratios are well established in determining an indication for percutaneous coronary intervention (PCI) in patients with coronary artery disease (CAD). In addition, over the last 5 years we have witnessed a shift towards the use of physiology to enhance procedural planning, assess post-PCI functional results, and guide PCI optimisation. In this regard, clinical studies have reported compelling data supporting the use of longitudinal vessel analysis, obtained with pressure guidewire pullbacks, to better understand how obstructive CAD contributes to myocardial ischaemia, to establish the likelihood of functionally successful PCI, to identify the presence and location of residual flow-limiting stenoses and to predict long-term outcomes. The introduction of new functional coronary angiography tools, which merge angiographic information with fluid dynamic equations to deliver information equivalent to intracoronary pressure measurements, are now available and potentially also applicable to these endeavours. Furthermore, the ability of longitudinal vessel analysis to predict the functional results of stenting has played an integral role in the evolving field of simulated PCI. Nevertheless, it is important to have an awareness of the value and challenges of physiology-guided PCI in specific clinical and anatomical contexts. The main aim of this European Association of Percutaneous Cardiovascular Interventions clinical consensus statement is to offer up-to-date evidence and expert opinion on the use of applied coronary physiology for procedural PCI planning, disease pattern recognition and post-PCI optimisation.
KW - fractional flow reserve
KW - intravascular ultrasound
KW - non-invasive imaging
UR - http://www.scopus.com/inward/record.url?scp=85168428319&partnerID=8YFLogxK
U2 - https://doi.org/10.4244/EIJ-D-23-00194
DO - https://doi.org/10.4244/EIJ-D-23-00194
M3 - Article
C2 - 37171503
SN - 1774-024X
VL - 19
SP - 464
EP - 481
JO - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
JF - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
IS - 6
ER -