Intravascular Imaging versus Physiological Assessment versus Biomechanics-Which Is a Better Guide for Coronary Revascularization.
Miłosz StarczyńskiStanisław DudekPiotr BaruśEmilia NiedzieskaMateusz WawrzeńczykDorota OchijewiczAdam PiaseckiKarolina GumiężnaKrzysztof MilewskiMarcin GrabowskiJanusz KochmanMariusz TomaniakPublished in: Diagnostics (Basel, Switzerland) (2023)
Today, coronary artery disease (CAD) continues to be a prominent cause of death worldwide. A reliable assessment of coronary stenosis represents a prerequisite for the appropriate management of CAD. Nevertheless, there are still major challenges pertaining to some limitations of current imaging and functional diagnostic modalities. The present review summarizes the current data on invasive functional and intracoronary imaging assessment using optical coherence tomography (OCT), and intravascular ultrasound (IVUS). Amongst the functional parameters-on top of fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR)-we point to novel angiography-based measures such as quantitative flow ratio (QFR), vessel fractional flow reserve (vFFR), angiography-derived fractional flow reserve (FFRangio), and computed tomography-derived flow fractional reserve (FFR-CT), as well as hybrid approaches focusing on optical flow ratio (OFR), computational fluid dynamics and attempts to quantify the forces exaggerated by blood on the coronary plaque and vessel wall.
Keyphrases
- coronary artery disease
- optical coherence tomography
- computed tomography
- high resolution
- percutaneous coronary intervention
- coronary artery
- coronary artery bypass grafting
- cardiovascular events
- magnetic resonance imaging
- diabetic retinopathy
- positron emission tomography
- dual energy
- type diabetes
- big data
- machine learning
- optic nerve
- heart failure
- electronic health record
- left ventricular
- deep learning