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Current Cardiology Reviews

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ISSN (Print): 1573-403X
ISSN (Online): 1875-6557

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Review Article

The Role of Coronary Physiology in Contemporary Percutaneous Coronary Interventions

Author(s): Federico Marin*, Roberto Scarsini, Dimitrios Terentes-Printzios, Rafail A. Kotronias, Flavio Ribichini, Adrian P. Banning and Giovanni Luigi De Maria

Volume 18, Issue 1, 2022

Published on: 07 December, 2021

Article ID: e080921196264 Pages: 19

DOI: 10.2174/1573403X17666210908114154

Price: $65

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).

Keywords: Coronary physiology, myocardial revascularization, functional assessment, percutaneous coronary intervention, ischemic heart disease, microvascular dysfunction.

Graphical Abstract

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