INTRODUCTION AND OBJECTIVES Intracoronary ultrasound estimation of the functional significance of intermediate angiographic lesions has mainly been based on measuring the minimal lumen area. These estimates take no account of lesion length and pay insufficient attention to long coronary lesions. METHODS We included 61 lesions with visual angiographic stenosis of 40% to 70% that required treat...

INTRODUCTION AND OBJECTIVES Multivessel disease is usually present in almost half of patients with acute coronary syndromes. Angiography is insufficiently accurate to decide on coronary revascularization in moderate nonculprit lesions. There is some debate about the usefulness of fractional flow reserve assessed by intracoronary pressure wire in acute coronary syndromes. We studied the results ...

Heyndrickx GR. Intracoronary and intravenous adenosine 50-triphosphate, adenosine, papaverine, and contrast medium to assess fractional flow reserve in humans. Circulation 2003;107:1877–1883. 21. Pijls N, van Son J, Kirkeeide R, De Bruyne B, Gould K. Experimental basis of determining maximum coronary, myocardial, and collateral blood flow by pressure measurements for assessing functional stenos...

Fractional flow reserve derived from coronary computed tomography angiography enables noninvasive assessment of the hemodynamic significance of coronary artery lesions and coupling of the anatomic severity of a coronary stenosis with its physiological effects. Since its initial demonstration of feasibility of use in humans in 2011, a significant body of clinical evidence has developed to evalua...

Various coronary physiological measurements can be made in the cardiac catheterization laboratory using sensor-tipped guidewires; they include the measurement of poststenotic absolute coronary flow reserve, the relative coronary flow reserve, and the pressure-derived fractional flow reserve of the myocardium. Ambiguity regarding abnormal microcirculation has been reduced or eliminated with meas...

Longitudinal stent deformation (LSD) is a rare complication but can occur during coronary intervention. We report a case with LSD of the distal edge, documented by an optical coherence tomography investigation and successfully recovered.

In this issue of JACC: Cardiovascular Interventions, Tu et al. (1) report on an initial validation study for a less-invasive approach to derive fractional flow reserve (FFR) based on the coronary angiogram. The investigators should be congratulated on developing an innovative means to expand the diagnostic value of angiography by including physiological ischemic assessment, potentially broadeni...

Pressure wire-based fractional flow reserve is considered the standard of reference for evaluation of the ischemic potential of coronary stenoses and the expected benefit from revascularization. Accordingly, its application in daily practice or for research purposes has to be as standardized as possible to avoid technical or operator-related artifacts in pressure recordings. This document propo...

Ma Fractional flow reserve (FFR) is the “gold standard” for assessing the physiological significance of coronary artery disease during invasive coronary angiography. FFR-guided percutaneous coronary intervention improves patient outcomes and reduces stent insertion and cost; yet, due to several practical and operator related factors, it is used in <10% of percutaneous coronary intervention proc...