TY - JOUR
T1 - Invasive Coronary Physiology Study in Multivessel Coronary Artery Disease
AU - Zahidin, Agita Maryalda
AU - Alkatiri, Amir Aziz
AU - Mangkuanom, Arwin Saleh
AU - Iryuza, Nanda
AU - Firman, Doni
N1 - Publisher Copyright:
© 2022 Thieme Medical Publishers, Inc.. All rights reserved.
PY - 2022
Y1 - 2022
N2 - Assessment of relationship between the angiographic stenosis severity and the coronary blood flow is complex. Coronary angiography has many limitations that may impair the judgment of stenosis severity and then affect decision-making regarding intervention. Myocardial perfusion imaging by single-photon emission tomography (MPI-SPECT) is used for a long time to help clinical decisions of interventions, but has limitations, such as issues with identification of extensive coronary artery disease (CAD). Fractional flow reserve (FFR) is a gold standard index for investigating the physiological significance of a coronary stenosis. The instantaneous wave-free ratio (iFR) is a hyperemia-free measurement and easier method to achieve physiological assessment to measure the severity of coronary stenosis. We present a case of multivessel coronary artery disease (MVCAD) patient who was treated with iFR-guided percutaneous coronary intervention (PCI) and emphasize the importance of physiological assessment in PCI.A 63-year-old male with multiple cardiovascular risk factors came to our center with chief complaint of stable angina since 1 year. He underwent MPI-SPECT and the result showed 2.5% of ischemia burden. Coronary angiography showed MVCAD. Surgical conference decided to do PCI. iFR-guided PCI was performed in this case.Our case highlights the importance of iFR as an important cardiology-physiology-based tool as a guide in management decisions for MVCAD. iFR as an alternative approach to physiological study is noninferior compared with FFR-guided PCI.
AB - Assessment of relationship between the angiographic stenosis severity and the coronary blood flow is complex. Coronary angiography has many limitations that may impair the judgment of stenosis severity and then affect decision-making regarding intervention. Myocardial perfusion imaging by single-photon emission tomography (MPI-SPECT) is used for a long time to help clinical decisions of interventions, but has limitations, such as issues with identification of extensive coronary artery disease (CAD). Fractional flow reserve (FFR) is a gold standard index for investigating the physiological significance of a coronary stenosis. The instantaneous wave-free ratio (iFR) is a hyperemia-free measurement and easier method to achieve physiological assessment to measure the severity of coronary stenosis. We present a case of multivessel coronary artery disease (MVCAD) patient who was treated with iFR-guided percutaneous coronary intervention (PCI) and emphasize the importance of physiological assessment in PCI.A 63-year-old male with multiple cardiovascular risk factors came to our center with chief complaint of stable angina since 1 year. He underwent MPI-SPECT and the result showed 2.5% of ischemia burden. Coronary angiography showed MVCAD. Surgical conference decided to do PCI. iFR-guided PCI was performed in this case.Our case highlights the importance of iFR as an important cardiology-physiology-based tool as a guide in management decisions for MVCAD. iFR as an alternative approach to physiological study is noninferior compared with FFR-guided PCI.
KW - instantaneous wave-free ratio
KW - multivessel coronary artery disease
KW - percutaneous coronary intervention
KW - physiology study
UR - http://www.scopus.com/inward/record.url?scp=85144882405&partnerID=8YFLogxK
U2 - 10.1055/s-0042-1759620
DO - 10.1055/s-0042-1759620
M3 - Article
AN - SCOPUS:85144882405
SN - 1061-1711
JO - International Journal of Angiology
JF - International Journal of Angiology
ER -