Technical Aspects and Clinical Indications of FFR
|
|
|
- Samuel Doyle
- 6 years ago
- Views:
Transcription
1 Technical Aspects and Clinical Indications of FFR Emanuele Barbato, MD, PhD, FESC Cardiovascular Center Aalst - OLV Clinic Aalst, Belgium
2 Potential conflicts of interest Consulting fees and honoraria on my behalf go to the Cardiovascular Research Center Aalst Contracted Research between the Cardiovascular Research Center Aalst and the following pharmaceutical and device companies: Ablynx, Astra Zeneca, BMS, Eli Lilly, GSK, Therabel, Abbott Vascular, Biotronik, Boston Scientific, Cordis J&J, Edwards, Medtronic, Orbus Neich, St Jude, Terumo Ownership Interest: Cardiovascular Research Center Aalst is cofounder of Cardio³BioSciences, a start-up company focusing on cellbased regenerative cardiovascular therapies
3 Technical Aspects P a P d + + = FFR
4 How to... equalize Pd and Pa P d P a Sensor of the pressure wire should be positioned outside the guiding catheter and proximal to the lesion to be measured!
5
6 How to... position the Pw P d P a Pressure wire should be positioned distal to the stenosis: note that pressure sensor is located at 3 cm from the tip!
7 How to... Induce maximal hyperemia + =
8 Why maximal hyperemia is important? NO MAXIMAL HYPEREMIA NO FFR!
9 No maximal hyperemia No FFR! Flow (Q) FFR = S Q max N Q max = P d P a CFR = Q max Q rest Coronary Pressure (P)
10 Why maximal hyperemia is important? A maximal hyperemia is important for the correct measurement of FFR A maximal hyperemia is fundamental for the correct clinical decision making
11 Coronary Hyperemic Stimuli Intravenous Infusion (preferable central line) - Adenosine 140 mg/kg/min Intracoronary Bolus LCA RCA - Adenosine > 100mg (up to mg) - Papaverine 20 mg 10 mg
12 Side effects Rarely AV-block (transient) With IV infusion: blood pressure drop (10-15%), angina-like chest pain or shortness of breath, possible bronchospasm in patients with COPD, very rarely AV-block
13 Two Compartment Model of the Coronary Circulation Epicardial Artery Microvasculature Nitrates (ISDN 200 µg IC) Adenosine, etc, Vasoconstriction Autoregulation
14 BEFORE NITRATES AFTER NITRATES
15 WITH ADENOSINE WITH NITRATES AND ADENOSINE
16 True maximal hyperemia Minimal microvascular resistance Minimal epicardial resistance: IC NTG!
17 True maximal hyperemia Minimal microvascular resistance Minimal epicardial resistance: IC NTG!
18 P a S.L.: 55-y-old woman 6 days post Q-wave anterior infarction. P d Adenosine P = 10 mm Hg P = 33 mm Hg FFR = 42 / 75 = 0.56
19 Resting Pressures and Hyperemia Berry C et al (VERIFY study) JACC 2012 in press
20 P a S.L.: 55-y-old woman 6 days post Q-wave anterior infarction. P d Adenosine P = 10 mm Hg P = 33 mm Hg FFR = 42 / 75 = 0.56
21 Clinical Indications Intermediate stenosis Equivocal stenosis of Left Main CA Aorto-Ostial and serial stenosis Multivessel disease Bifurcation Small vessel disease ACS
22 Clinical Indications Intermediate stenosis Equivocal stenosis of Left Main CA Aorto-Ostial and serial stenosis Multivessel disease Bifurcation Small vessel disease ACS
23
24 QCA vs. FFR in LM stenosis 6% 23% Hamilos M et al Circulation 2009
25 Visual estimation vs. FFR 74% concordance 26% different estimation: Half had a DS>50%, but a FFR > 0.80 Half had a DS<50%, but a FFR < 0.80 Hamilos M et al Circulation 2009
26 How to... measure FFR in the LMCA P a P d Equalization of 2 pressures (guiding catheter [P a ] and PW [P d ]): to be perfomed with the GC disengaged!
27 GC disengaged GC engaged 5th European Interventional Cardiology Fellows Course, London, November 2010
28 GC disengaged GC engaged 5th European Interventional Cardiology Fellows Course, London, November 2010
29 New Equalization GC disengaged GC engaged 5th European Interventional Cardiology Fellows Course, London, November 2010
30 GC disengaged GC engaged New Equalization 5th European Interventional Cardiology Fellows Course, London, November 2010
31 GC disengaged GC engaged New Equalization 5th European Interventional Cardiology Fellows Course, London, November 2010
32 How to... measure FFR in the LMCA P a P d
33 How to... measure FFR in the LMCA P a P d Hyperemia with IV Adenosine infusion is strictly recommended!
34 How to... measure FFR in the LMCA P a P d With distal stenosis, FFR should be measured in both LAD
35 How to... measure FFR in the LMCA P a P d and LCX!
36 Hamilos M et al Circulation 2009
37 Hamilos M et al Circulation 2009
38 Survival at long term follow-up MACE free-survival Hamilos M et al Circulation 2009
39 Clinical Indications Intermediate stenosis Equivocal stenosis of Left Main CA Aorto-Ostial and serial stenosis Multivessel disease Bifurcation Small vessel disease ACS
40 GM 77 year-old-female Risk factors Arterial hypertension Past medical history July 2005: mid-cab with LIMA to LAD March 2007: stable angina
41 MIBI (March 2007)
42 GM 77 year-old-female CAG (May 2007) Mid-LAD 100%, LIMA to LAD patent, collaterals to LAD also from the RCA. Medical treatment.
43 October 2010 Clinical Presentation Worsening of angina
44 CAG (November 2010)
45 CAG (November 2010)
46 CAG (November 2010)
47 CAG (November 2010)
48 FFR mid-rca (November 2010)
49 FFR mid-rca (November 2010)
50 FFR mid-rca (November 2010)
51
52 FFR ostial + mid-rca
53 FFR ostial + mid-rca Started Infusion of IV adenosine (140 mg/kg/min)
54
55 PCI ostial-rca BMS 4.0 x 15 mm
56 PCI ostial- RCA NCB 4.5 x 8 mm
57 Control Angio
58
59 PCI mid-rca BMS 3.5 x 15 mm
60 Final Angiography
61 Clinical Indications Intermediate stenosis Left Main and isolated proximal LAD Aorto-Ostial and serial stenosis Multivessel disease Bifurcation Small vessel disease ACS
62 Specificity of small vessel disease No correlation between functional (by FFR) and anatomic (both by QCA and IVUS) stenosis severity
63 No correlation between FFR, QCA and IVUS Costa M et al Am Heart J 2007
64 Specificity of small vessel disease No correlation between functional (by FFR) and anatomic (both by QCA and IVUS) stenosis severity Generally supply small areas of myocardium at risk
65 Small vessels, myocardial mass and FFR Costa M et al Am Heart J 2007
66 Specificity of small vessel disease No correlation between functional (by FFR) and anatomic (both by QCA and IVUS) stenosis severity Generally supply small areas of myocardium at risk Revascularization of SVD can be technically challenging Higher risk of restenosis and target vessel failure
67 FFR-guided PCI in small vessel disease Puymirat E et al Circulation Cardiovasc Intv 2012
68 FFR-guided PCI in small vessel disease Puymirat E et al Circulation Cardiovasc Intv 2012
69 Conclusions FFR measurement, when appropriately performed, is a validated surrogate index for myocardial ischemia FFR can help clinical decision making in different anatomical and clinical settings Randomized studies and registries have demonstrated in thousands of patients that an FFR-guided revascularization is safe and effective (Class IA in the latest ESC/EACTS guidelines)
Focus on Acute Coronary Syndromes
Focus on Acute Coronary Syndromes Emanuele Barbato, MD, PhD, FESC Cardiovascular Center Aalst, Belgium Potential conflicts of interest Consulting fees and honoraria on my behalf go to the Cardiovascular
Fractional Flow Reserve (FFR) --Practical Set Up Pressure Measurement --
Fractional Flow Reserve (FFR) --Practical Set Up Pressure Measurement -- Joon Hyung Doh, MD, PhD Associate Professor, Division of Cardiology Inje University Ilsan Paik Hospital Goyang, Korea 목차 Fractional
Fractional Flow Reserve (FFR) --Practical Set Up Pressure Measurement --
Fractional Flow Reserve (FFR) --Practical Set Up Pressure Measurement -- JoonHyung Doh, MD, PhD Assistant Professor, Vision21 Cardiac and Vascular Center Inje University Ilsan Paik Hospital Goyang, Korea
Fractional Flow Reserve: Basics, FAME 1, FAME 2. William F. Fearon, MD Associate Professor Stanford University Medical Center
Fractional Flow Reserve: Basics, FAME 1, FAME 2 William F. Fearon, MD Associate Professor Stanford University Medical Center Conflict of Interest Advisory Board for HeartFlow Research grant from St. Jude
Diffuse Disease and Serial Stenoses
Diffuse Disease and Serial Stenoses Bernard De Bruyne Cardiovascular Center Aalst Belgium Atherosclerosis is a Diffuse Disease Serial Stenoses A B P a P m P d When A is isolated, hyperemic flow through
Diffuse Disease and Serial Stenoses. Bernard De Bruyne Cardiovascular Center Aalst Belgium
Diffuse Disease and Serial Stenoses Bernard De Bruyne Cardiovascular Center Aalst Belgium Atherosclerosis is a Diffuse Disease Serial Stenoses A B P a P m P d When A is isolated, hyperemic flow through
Debate Should we use FFR? I will say NO.
Debate Should we use FFR? I will say NO. Hyeon-Cheol Gwon Cardiac and Vascular Center Samsung Medical Center Sungkyunkwan University School of Medicine Dr. Hyeon-Cheol Gwon Research fund from Abbott Korea
FFR in Left Main Disease
FFR in Left Main Disease William F. Fearon, MD Associate Professor of Medicine Director, Interventional Cardiology Stanford University Medical Center Why FFR instead of IVUS? Physiologic versus anatomic
La FFR quoi d autre: En pratique? Pierre Deharo, CHU TIMONE, Marseille
La FFR quoi d autre: En pratique? Pierre Deharo, CHU TIMONE, Marseille La FFR quoi d autre: En pratique? How to avoid non reliable results Management of MVD Non Culprit in STEMI Left main Severe AS Post
FFR: Tips and Tricks. A/Prof (Adj) Yeo Khung Keong, MBBS, FAMS, FACC, FSCAI National Heart Centre Singapore
FFR: Tips and Tricks A/Prof (Adj) Yeo Khung Keong, MBBS, FAMS, FACC, FSCAI National Heart Centre Singapore Disclosures Abbott Vascular: Speaker, Proctor (MitraClip) Boston Scientific: Consultant, honorarium
FRACTIONAL FLOW RESERVE USE IN THE CATH LAB BECAUSE ANGIOGRAPHY ALONE IS NOT ENOUGH!!!!!!!!
FRACTIONAL FLOW RESERVE USE IN THE CATH LAB BECAUSE ANGIOGRAPHY ALONE IS NOT ENOUGH!!!!!!!! Juan Antonio Pastor-Cervantes,M.D FSCAI, FACC Cardiovascular Institute Memorial Regional Hospital Hollywood Florida
FRACTIONAL FLOW RESERVE Step-by-step measurement, Practical tips & Pitfalls
FRACTIONAL FLOW RESERVE Step-by-step measurement, Practical tips & Pitfalls Ahmed M ElGuindy, MSc, MRCP(UK) Division of Cardiology Aswan Heart Centre 2013 Fractional Flow Reserve Essential diagnostic tool
Fractional Flow Reserve. A physiological approach to guide complex interventions
Fractional Flow Reserve A physiological approach to guide complex interventions What is FFR? Fractional Flow Reserve (FFR) is a lesion specific, physiological index determining the hemodynamic severity
Instantaneous Wave-Free Ratio
Instantaneous Wave-Free Ratio Alejandro Aquino MD Interventional Cardiology Fellow Washington University in St. Louis Barnes-Jewish Hospital Instantaneous Wave-Free Ratio Alejandro Aquino MD Disclosure
PCIs on Intermediate Lesions NCDR Cath-PCI Registry
Practical Application Of Coronary Physiology in The Cath Lab Talal T Attar, MD, MBA, FACC PCIs on Intermediate Lesions NCDR Cath-PCI Registry Fraction of stenoses 50-70% treated with PCI without further
Fractional Flow Reserve: Review of the latest data
Fractional Flow Reserve: Review of the latest data Michalis Hamilos, MD, PhD, FESC University Hospital of Heraklion Fractional Flow Reserve (FFR) Coronary angiography does not always tell the truth Most
FFR and CABG Emanuele Barbato, MD, PhD, FESC Cardiovascular Center Aalst, Belgium
FFR and CABG Emanuele Barbato, MD, PhD, FESC Cardiovascular Center Aalst, Belgium Conflict of Interest Institutional research grants and speaker s fee from St. Jude Medical and Boston Scientic to Cardiovascular
FFR Incorporating & Expanding it s use in Clinical Practice
FFR Incorporating & Expanding it s use in Clinical Practice Suleiman Kharabsheh, MD Consultant Invasive Cardiology Assistant professor, Alfaisal Univ. KFHI - KFSHRC Concept of FFR Maximum flow down a vessel
Clinical case in perspective. Cases from Poland
Clinical case in perspective Cases from Poland Assoc. Prof. Jacek Legutko, MD, PhD President-Elect of the Association for Percutaneous Cardiovascular Interventions of the Polish Cardiac Society Institute
FFR= Qs/Qn. Ohm s law R= P/Q Q=P/R
32 ο Πανελλήνιο Καρδιολογικό Συνζδριο, Θεσσαλονίκη 20/10/2011 Gould KL et al, JACC CARDIOVASC IMAG 2009 Gould KL et al AM J CARDIOL 1974 & JACC CARDIOVASC IMAG 2009 Under maximal hyperemia: Rs=Rn FFR=
Fractional Flow Reserve and instantaneous wave -free Ratio. Λάμπρος Κ. Μόσιαλος Επεμβατικός Καρδιολόγος ΓΝ Παπαγεωργίου
Fractional Flow Reserve and instantaneous wave -free Ratio Λάμπρος Κ. Μόσιαλος Επεμβατικός Καρδιολόγος ΓΝ Παπαγεωργίου DISCLOSURES There are no financial conflicts of interest relevant to this presentation
FRACTIONAL FLOW RESERVE: STANDARD OF CARE
FRACTIONAL FLOW RESERVE: FROM INVESTIGATIONAL TOOL TO STANDARD OF CARE TCT ASIA Seoul, Korea, april 26 th, 2012 Nico H. J. Pijls, MD, PhD Catharina Hospital, Eindhoven, The Netherlands FRACTIONAL FLOW
Jose Mª de la Torre Hernandez, MD, PhD, FESC. Cardiologia Valdecilla Hospital Universitario Marques de Valdecilla Santander. SPAIN
Validation and application of IVUS-MLA in LMCA disease Jose Mª de la Torre Hernandez, MD, PhD, FESC Interventional Cardiology Dpt Cardiologia Valdecilla Hospital Universitario Marques de Valdecilla Santander.
ROLE OF CORONARY PRESSURE & FFR IN MULTIVESSEL DISEASE
ROLE OF CORONARY PRESSURE & FFR IN MULTIVESSEL DISEASE Angioplasty Summit TCT ASIA Seoul, Korea, april 24th, 2008 Nico H. J. Pijls, MD, PhD Catharina Hospital, Eindhoven, The Netherlands A rather common
Coronary stenting: the appropriate use of FFR
Coronary stenting: the appropriate use of FFR Morton J. Kern, MD Professor of Medicine Chief of Cardiology LBVA Associate Chief Cardiology University California Irvine Orange, California To treat or not
Between Coronary Angiography and Fractional Flow Reserve
Visual-Functional Mismatch Between Coronary Angiography and Fractional Flow Reserve Seung-Jung Park, MD., PhD. University of Ulsan, College of Medicine Asan Medical Center, Seoul, Korea Visual - Functional
Pressure Wire Study. Fractional Flow Reserve (FFR) Nishat Jahagirdar Principal Clinical Cardiac Physiologist Kings College Hospital
Pressure Wire Study Fractional Flow Reserve (FFR) Nishat Jahagirdar Principal Clinical Cardiac Physiologist Kings College Hospital History Andreas Gruentzig s paper on Non operative dilation of coronaryartery
Case Review: Borderline LM with IVUS and FFR. Ravi Ramana, DO Heart Care Centers of Illinois SCAI Annual Conference 2010
Case Review: Borderline LM with IVUS and FFR Ravi Ramana, DO Heart Care Centers of Illinois SCAI Annual Conference 2010 Disclosures No relevant disclosures. Borderline Left Main Disease Significant LMS
Integrated Use of IVUS and FFR for LM Stenting
Integrated Use of IVUS and FFR for LM Stenting Gary S. Mintz, MD Cardiovascular Research Foundation Four studies have highlighted the inaccuracy of angiography in the assessment of LMCA disease Fisher
LM stenting - Cypher
LM stenting - Cypher Left main stenting with BMS Since 1995 Issues in BMS era AMC Restenosis and TLR (%) 3 27 TLR P=.282 Restenosis P=.71 28 2 1 15 12 Ostium 5 4 Shaft Bifurcation Left main stenting with
8 th European Bifurcation Club October Barcelona
8 th European Bifurcation Club 12-13 October 2012 - Barcelona Jose Mª de la Torre Hernandez, MD, PhD, FESC Interventional Cardiology Dpt Cardiologia Valdecilla Hospital Universitario Marques de Valdecilla
Side Branch Occlusion
Side Branch Occlusion Mechanism, Outcome, and How to avoid it From COBIS II Registry Hyeon-Cheol Gwon Cardiac&Vascular Center, Samsung Medical Center Sungkyunkwan University School of Medicine SB occlusion
Drug Eluting Stents overhyped, overused and overpriced?
Advanced Angioplasty 2008 BCIS 23 rd Jan 2008 Drug Eluting Stents overhyped, overused and overpriced? William Wijns MD, PhD Cardiovascular Center Aalst http://www.cardio-aalst.be William.Wijns@village.uunet.be
Prognostic Value of Gated Myocardial Perfusion SPECT
Current Use of IVUS & FFR George D. Dangas, MD, PhD, FACC, FSCAI Professor of Medicine Mount Sinai School of Medicine Prognostic Value of Gated Myocardial Perfusion SPECT 0.6% / year, Cardiac Death and
Le# Main Interven-on: When Is It Appropriate. Femi Philip, MD Assistant Professor Of Medicine UC Davis
Le# Main Interven-on: When Is It Appropriate Femi Philip, MD Assistant Professor Of Medicine UC Davis Nil Disclosures Outline What is the LMCA? Should we revascularize severe LMCA disease? What revascularizacon
FFR in diffuse disease and serial stenoses
FFR in diffuse disease and serial stenoses Educational Training Program ESC European Heart House Apr. 25-27 2013 Nils Witt MD PhD, Södersjukhuset, Stockholm, Sweden Single stenosis Functionally Functional
FFR and intravascular imaging, which of which?
FFR and intravascular imaging, which of which? Ayman Khairy MD, PhD, FESC Associate professor of Cardiovascular Medicine Vice Director of Assiut University Hospitals Assiut, Egypt Diagnostic assessment
Fractional Flow Reserve and the 1 Year Results of the FAME Study
Imaging and Physiology Summit Seoul, Korea, November 22, 2008 Fractional Flow Reserve and the 1 Year Results of the FAME Study William F. Fearon, M.D. Assistant Professor Division of Cardiovascular Medicine
Basics of Angiographic Interpretation Analysis of Angiography
Basics of Angiographic Interpretation Analysis of Angiography Young-Hak Kim, MD, PhD Cardiac Center, University of Ulsan College of Medicine, Seoul, Korea What made us nervous Supervisors Stent Contrast
Control of Myocardial Blood Flow
Control of Myocardial Blood Flow Blood goes where it is needed John Hunter, 1794 Cited by Dunker DJ and Bache RJ Physiol Rev, 2008 Bernard De Bruyne, MD, PhD Cardiovascular Center Aalst OLV-Clinic Aalst,
CASE from South Korea
CASE from South Korea Bon-Kwon Koo, MD, PhD, Seoul, Korea Outpatient clinic of a non-interventional cardiologist F/56 Chief complaint: Angina with recent aggravation, CCS II~III Brief history: # Stroke
CLINICAL CONSEQUENCES OF THE
CLINICAL CONSEQUENCES OF THE FAME STUDY TCT ASIA Seoul, Korea, april 26 th, 2012 Nico H. J. Pijls, MD, PhD Catharina Hospital, Eindhoven, The Netherlands GUIDELINES ESC SEPTEMBER 2010 FFR UPGRADED TO LEVEL
Effect of Intravascular Ultrasound- Guided vs. Angiography-Guided Everolimus-Eluting Stent Implantation: the IVUS-XPL Randomized Clinical Trial
Effect of Intravascular Ultrasound- Guided vs. Angiography-Guided Everolimus-Eluting Stent Implantation: the IVUS-XPL Randomized Clinical Trial Myeong-Ki Hong, MD. PhD on behalf of the IVUS-XPL trial investigators
Unprotected LM intervention
Unprotected LM intervention Guideline for COMBAT Seung-Jung Park, MD, PhD Professor of Internal Medicine, Seoul, Korea Current Recommendation for unprotected LMCA Stenosis Class IIb C in ESC guideline
Effects of Increasing Doses of Intracoronary Adenosine on the Assessment of Fractional Flow Reserve
JACC: CARDIOVASCULAR INTERVENTIONS VOL. 4, NO. 10, 2011 2011 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-8798/$36.00 PUBLISHED BY ELSEVIER INC. DOI: 10.1016/j.jcin.2011.08.004 Effects of
Relations of Interest
Relations of Interest Consulting Fees on my behalf go to the Cardiovascular Research Center Aalst Contracted Research between the Cardiovascular Research Center Aalst and several pharmaceutical and device
Calculation of the Index of Microcirculatory Resistance without Coronary Wedge Pressure Measurement in the Presence of Epicardial Stenosis
Calculation of the Index of Microcirculatory Resistance without Coronary Wedge Pressure Measurement in the Presence of Epicardial Stenosis ASC Yong 1,2, M Ho 3, MG Shah 3, D Daniels 3, C Chawantanpipat
Left Main Intervention: Will it become standard of care?
Left Main Intervention: Will it become standard of care? David Cox, MD FSCAI, FACC Director, Interventional Cardiology Research Associate Director, Cardiac Cath Lab Lehigh Valley Health Network Allentown,
Post PCI functional testing and imaging: case based lessons from FFR React
Post PCI functional testing and imaging: case based lessons from FFR React Joost Daemen, MD, PhD, FESC Optics in Cardiology 2018 April 21st, 2018 10.15 10.30h Disclosure Statement of Financial Interest
Dave Kettles, St Dominics Hospital East London.
Dave Kettles, St Dominics Hospital East London. 110 x 150 Angina for a couple of months Trop T negative T wave inversion across the chest leads Not wanting to risk radial Huge struggle with femoral
Left Main Intervention: Where are we in 2015?
Left Main Intervention: Where are we in 2015? David A. Cox, MD FSCAI Director, Cardiology Research Associate Director, Cardiac Cath Lab Lehigh Valley Health Network Allentown, PA Fall Fellows Course Laa
Left Main PCI. Integrated Use of IVUS and FFR. Seung-Jung Park, MD, PhD
Left Main PCI Integrated Use of IVUS and FFR Seung-Jung Park, MD, PhD Professor of Medicine, University of Ulsan College of Medicine, Heart Institute, Asan Medical Center, Seoul, Korea Efficacy of Left
ISAR-LEFT MAIN: A Randomized Clinical Trial on Drug-Eluting Stents for Unprotected Left Main Lesions
Julinda Mehilli, MD Deutsches Herzzentrum Technische Universität Munich Germany ISAR-LEFT MAIN: A Randomized Clinical Trial on Drug-Eluting Stents for Unprotected Left Main Lesions Background Left main
Coronary Physiology and FFR. David H. Sibley MD FACC, FSCAI, FACP
Coronary Physiology and FFR David H. Sibley MD FACC, FSCAI, FACP Braunwald s Heart Disease, 7 th Edition Control of Coronary Blood Flow 1. CFR = max flow/basal flow and decreases with increasing stenosis
Bifurcation stenting with BVS
Bifurcation stenting with BVS Breaking the limits or just breaking the struts? Maciej Lesiak Department of Cardiology University Hospital in Poznan, Poland Disclosure Speaker s name: Maciej Lesiak I have
Plaque Shift vs. Carina Shift Prevalence and Implication
TCTAP 2013 Fellowship Course Left Main and Bifurcation PCI: Bifurcation PCI Plaque Shift vs. Carina Shift Prevalence and Implication Soo-Jin Kang, MD., PhD. Department of Cardiology, University of Ulsan
Benefit of Performing PCI Based on FFR
Benefit of Performing PCI Based on FFR William F. Fearon, MD Associate Professor Director, Interventional Cardiology Stanford University Medical Center Benefit of FFR-Guided PCI FFR-Guided PCI vs. Angiography-Guided
ORIGINAL ARTICLE. Abstract. Introduction
ORIGINAL ARTICLE A Comparison between the Instantaneous Wave-free Ratio and Resting Distal Coronary Artery Pressure/Aortic Pressure and the Fractional Flow Reserve: The Diagnostic Accuracy CanBeImprovedbytheUseofbothIndices
FFR vs icecg in Coronary Bifurcations FIESTA ClinicalTrials.gov Identifier: NCT
FFR vs icecg in Coronary Bifurcations FIESTA ClinicalTrials.gov Identifier: NCT01724957 Dobrin Vassilev MD, PhD Assoc. Prof. in Cardiology Head Cardiology Clinic, Alexandrovska University Hospital Medical
New Insight about FFR and IVUS MLA
New Insight about FFR and IVUS MLA Can IVUS MLA Predict FFR
FFR-guided Jailed Side Branch Intervention
FFR-guided Jailed Side Branch Intervention - Pressure wire in Bifurcation lesions - Bon-Kwon Koo, MD, PhD Seoul National University Hospital, Seoul, Korea Bifurcation Lesions Bifurcation Lesions Still
The Future of Coronary Physiology
The Future of Coronary Physiology Morton J. Kern, MD Chief of Medicine, VA Long Beach HCS Professor of Medicine University California Irvine Orange, California Disclosure: Morton J. Kern, MD Within the
Important LM bifurcation studies update
8 th European Bifurcation Club 12-13 October 2012 - Barcelona Important LM bifurcation studies update I Sheiban E-mail: isheiban@yahoo.com Unprotected LM Percutaneous Revascularization What is important
Case report. Resistance in the cath lab : the utility of hyperemic stenosis resistance in the functional assessment of coronary artery disease
Resistance in the cath lab : the utility of hyperemic stenosis resistance in the functional assessment of coronary artery disease Kalpa De Silva, Divaka Perera Cardiovascular Division, The Rayne Institute,
Application of Fractional Flow Reserve in the diagnostics of coronary artery disease
Application of Fractional Flow Reserve in the diagnostics of coronary artery disease PhD thesis Gábor G Tóth, MD Semmelweis University Doctoral School of Clinical Medicine Consultant: Official reviewers:
FFR in Multivessel Disease
FFR in Multivessel Disease April, 26 2013 Coronary Physiology in the Catheterization Laboratory Location: European Heart House, Nice, France Pim A.L. Tonino, MD, PhD Hartcentrum, Eindhoven, the Netherlands
Evaluation of Intermediate Coronary lesions: Can You Handle the Pressure? Jeffrey A Southard, MD May 4, 2013
Evaluation of Intermediate Coronary lesions: Can You Handle the Pressure? Jeffrey A Southard, MD May 4, 2013 Disclosures Consultant- St Jude Medical Boston Scientific Speaker- Volcano Corporation Heart
ΑΝΤΙΓΝΩΜΙΕΣ ΣΤΗΝ ΕΠΕΜΒΑΤΙΚΗ ΚΑΡΔΙΟΛΟΓΙΑ:Νόσος στελέχους Αγγειοπλαστική
ΑΝΤΙΓΝΩΜΙΕΣ ΣΤΗΝ ΕΠΕΜΒΑΤΙΚΗ ΚΑΡΔΙΟΛΟΓΙΑ:Νόσος στελέχους Αγγειοπλαστική X. ΓΡΑΪΔΗΣ Επεμβατικός καρδιολόγος, FSCAI Kλινική Euromedica-Κυανούς Σταυρός, Θεσσαλονίκη The Fear factor The two words LEFT MAIN
FFR-guided Complete vs. Culprit Only Revascularization in AMI Patients Ki Hong Choi, MD On Behalf of FRAME-AMI Investigators
FFR-guided Complete vs. Culprit Only Revascularization in AMI Patients Ki Hong Choi, MD On Behalf of FRAME-AMI Investigators Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Republic of
FFR? FFR-CT? Ischaemia testing?
FFR? FFR-CT? Ischaemia testing? Marco Zimarino, MD, PhD Institute of Cardiology - University G. d Annunzio, Chieti (Italy) Diagnostic management of patients with suspected stable CAD Risk stratification
Can We Safely Defer PCI. Yes, already proven
Can We Safely Defer PCI Just Based on FFR>0.80? Yes, already proven Seung-Jung Park, MD., PhD. Professor of Medicine, University of Ulsan, College of Medicine Heart Institute, Asan Medical Center, Seoul,
OCT guidance for distal LM lesions
OCT guidance for distal LM lesions FRANCESCO BURZOTTA INSTITUTE OF CARDIOLOGY CATHOLIC UNIVERSITY OF THE SACRED HEART ROME, ITALY LM suitability for OCT At FU in stented LM Parodi G et al. Eurointervention
IVUS-Guided d Provisional i Stenting: Plaque or Carina Shift. Soo-Jin Kang, MD., PhD.
Left Main and Bifurcation Summit IVUS-Guided d Provisional i Stenting: ti Plaque or Carina Shift Soo-Jin Kang, MD., PhD. Department of Cardiology, University of Ulsan College of Medicine Asan Medical Center,
Coronary interventions
Controversial issues in the management of ischemic heart failure Coronary interventions Maciej Lesiak Department of Cardiology, University Hospital in Poznan none DECLARATION OF CONFLICT OF INTEREST CHF
Mid-term results from real-world REPARA registry. Felipe Hernandez, on behalf of the REPARA investigators
Mid-term results from real-world REPARA registry Felipe Hernandez, on behalf of the REPARA investigators Potential conflicts of interest Speaker's name: Felipe Hernandez I have the following potential
Fractional Flow Reserve (FFR) estimation GRAIDIS CHRISTOS. EUROMEDICA-KYΑNOUS STAVROS Interventional Cardiologist, FSCAI
Fractional Flow Reserve (FFR) estimation Why, how, when? GRAIDIS CHRISTOS EUROMEDICA-KYΑNOUS STAVROS Interventional Cardiologist, FSCAI "Innovations in Interventional Cardiology & Electrophysiology IICE
ABSOLUTE BLOOD FLOW MEASUREMENTS: PRINCIPLES
CORONARY PHYSIOLOGY IN THE CATHLAB: ABSOLUTE BLOOD FLOW MEASUREMENTS: PRINCIPLES Educational Training Program ESC European Heart House april 23rd - 25th 2015 Nico H. J. Pijls, MD, PhD Catharina Hospital,
Factors influencing the functional significance in intermediate coronary stenosis
Journal of Geriatric Cardiology (2015) 12: 107 112 2015 JGC All rights reserved; www.jgc301.com Research Article Open Access Factors influencing the functional significance in intermediate coronary stenosis
Primary Results of the Assessment of Catheter-based Interrogation and Standard Techniques for Fractional Flow Reserve Measurement Study
Primary Results of the Assessment of Catheter-based Interrogation and Standard Techniques for Fractional Flow Reserve Measurement Study The ACIST-FFR Study William F. Fearon, MD, Jeffrey W. Chambers, MD,
Upgrade of Recommendation
Challenges in LM PCI Decision-making process for stenting Young-Hak Kim, MD, PhD, Heart Institute, University of Ulsan College of Medicine Asan Medical Center, Seoul, Korea Upgrade of Recommendation for
Cardiologic history. Anamnesis. Female BD Risk factors HTN, DM, Dyslipidaemia. Cardiologic Long history. Last admission Heart failure
Anamnesis Cardiologic history Female BD 29.7.1939 Risk factors HTN, DM, Dyslipidaemia Cardiologic Long history Last admission Heart failure 2004 NSTEMI CX stenosis DES on CX 2012 Acute Pulmonary Oedema
Aun-Yeong Chong MD, MRCP(UK), MBBS University of Ottawa Heart Institute
Aun-Yeong Chong MD, MRCP(UK), MBBS University of Ottawa Heart Institute Cardiac Imaging Symposium Oct 2013 Invasive Coronary Artery Assessment Coronary angiography IntraVascular UltraSound (IVUS) Optical
How to Evaluate Microvascular Function and Angina. Myeong-Ho Yoon Ajou University Hospital
How to Evaluate Microvascular Function and Angina Myeong-Ho Yoon Ajou University Hospital Angina without Coronary Artery Disease (CAD) Prevalence: 20-30% going c-angiography, with a higher prevalence (almost
Successful revascularization of LCX-CTO via a underlying
IPS/CTO LIVE 2012 ;@ Asan Medical Center, Seoul, Korea Successful revascularization of LCX-CTO via a underlying collateral l channel The Department of Cardiology, Daini i Okamoto general hospital Masaki
Primary Percutaneous Coronary Intervention
The big 5 in PCI Primary Percutaneous Coronary Intervention W. Wijns (Aalst, BE) Disclosures Consulting Fees: on my behalf go to the Cardiovascular Research Center Aalst Contracted Research between the
Coronary Artery Disease
Coronary Artery Disease Fractional Flow Reserve Assessment of Left Main Stenosis in the Presence of Downstream Coronary Stenoses Andy S.C. Yong, MBBS, PhD*; David Daniels, MD*; Bernard De Bruyne, MD, PhD;
The MAIN-COMPARE Study
Long-Term Outcomes of Coronary Stent Implantation versus Bypass Surgery for the Treatment of Unprotected Left Main Coronary Artery Disease Revascularization for Unprotected Left MAIN Coronary Artery Stenosis:
Patient. Clinical data Indications: Operation date. Comorbidities: Patient code Birth date: / /
Patient Patient code Birth date: / / Sex: Male Height (cm): Female Weight (kg): Risk Factors: Family history of coronary disease: Hypertension Dyslipidemia Peripheral disease Diabetes Comorbidities: No
Culprit Lesion Remodeling and Long-term (> 5years) Prognosis in Patients with Acute Coronary Syndrome
Culprit Lesion Remodeling and Long-term (> 5years) Prognosis in Patients with Acute Coronary Syndrome Hiroyuki Okura*, MD; Nobuya Matsushita**,MD Kenji Shimeno**, MD; Hiroyuki Yamaghishi**, MD Iku Toda**,
EBC London 2013 Provisional SB stenting strategy with kissing balloon with Absorb
EBC London 2013 Provisional SB stenting strategy with kissing balloon with Absorb A. Medina Servicio de Cardiología Hospital Universitario de Gran Canaria Dr. Negrín Islas Canarias (Spain) Provisional
What do the guidelines say?
Percutaneous coronary intervention in 3-vessel disease and main stem What do the guidelines say? Nothing to disclose Dariusz Dudek Institute of Cardiology, Jagiellonian University Krakow, Poland The European
Case Report Left Main Stenosis. Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Graft Surgery (CABG)?
Cronicon OPEN ACCESS CARDIOLOGY Case Report Left Main Stenosis. Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Graft Surgery (CABG)? Valentin Hristov* Department of Cardiology, Specialized
Catheter selection for transradial angiography and intervention
Catheter selection for transradial angiography and intervention Sandeep Nathan, MD, MSc, FACC, FSCAI Assistant Professor of Medicine Director, Interventional Cardiology Fellowship Program Director, Interventional
DEB experience in Gachon Universtiy Gil Hospital (in ISR) Soon Yong Suh MD., PhD. Heart Center Gachon University Gil Hospital Seoul, Korea.
DEB experience in Gachon Universtiy Gil Hospital (in ISR) Soon Yong Suh MD., PhD. Heart Center Gachon University Gil Hospital Seoul, Korea. In-stent restenosis (ISR) Remains important issue even in the
When Aspiration Thrombectomy Does Not Work? A A R O N W O N G N A T I O N A L H E A R T C E N T R E S I N G A P O R E
When Aspiration Thrombectomy Does Not Work? A A R O N W O N G N A T I O N A L H E A R T C E N T R E S I N G A P O R E Thrombus in STEMI Over 70% of STEMI patients has angiographic evidence of thrombus
Imaging and heart failure
Imaging and heart failure Jeroen J Bax Dept of Cardiology Leiden Univ Medical Center The Netherlands Davos, feb 2013 Research grants: Medtronic, Biotronik, Boston, St Jude, BMS imaging, GE Healthcare,
JACC: CARDIOVASCULAR INTERVENTIONS VOL. 4, NO. 7, PUBLISHED BY ELSEVIER INC. DOI: /j.jcin
JACC: CARDIOVASCULAR INTERVENTIONS VOL. 4, NO. 7, 2011 2011 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-8798/$36.00 PUBLISHED BY ELSEVIER INC. DOI: 10.1016/j.jcin.2011.03.013 Optimal Intravascular
EXCEL vs. NOBLE: How to Treat Left Main Disease in 2017 AATS International Cardiovascular Symposium December 8-9, 2017
EXCEL vs. NOBLE: How to Treat Left Main Disease in 2017 AATS International Cardiovascular Symposium December 8-9, 2017 Igor F. Palacios, MD Director of Interventional Cardiology Professor of Medicine Massachusetts
Coronary artery disease (CAD): Fractional Flow Reserve (FFR) for Pilots Risk Assessment. B. Haaff, R. Quast
Coronary artery disease (CAD): Fractional Flow Reserve (FFR) for Pilots Risk Assessment B. Haaff, R. Quast Aeromedical Center Germany, Stuttgart-Airport Westpfalz-Klinikum, Kaiserslautern, Germany Disclosure
STEMI ST Elevation Myocardial Infarction
STEMI ST Elevation Myocardial Infarction Breakout Session One Moderators: Quinn Capers IV, MD and Scott M. Lilly, MD, PhD Cases Presented by: Umair S. Ahmad, MD 1 Outline 1. Multivessel Revascularization