Physiologic Assessment after Coronary Stent Implantation

Doyeon Hwang; Seokhun Yang; Jinlong Zhang; Bon Kwon Koo

doi:10.4070/kcj.2020.0548

Physiologic Assessment after Coronary Stent Implantation

Korean Circ J. 2021 Mar;51(3):189-201. doi: 10.4070/kcj.2020.0548.

Authors

Doyeon Hwang^#¹, Seokhun Yang^#¹, Jinlong Zhang², Bon Kwon Koo³

Affiliations

¹ Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea.
² Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
³ Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea. bkkoo@snu.ac.kr.

^# Contributed equally.

Abstract

The presence of myocardial ischemia is a prerequisite for the benefit of coronary revascularization. In the cardiac catheterization laboratory, fractional flow reserve and non-hyperemic pressure ratios are used to define the ischemia-causing coronary stenosis, and several randomized studies showed the benefit of physiology-guided coronary revascularization. However, physiology-guided revascularization does not necessarily guarantee the relief of ischemia. Recent studies reported that residual ischemia might exist in up to 15-20% of cases after angiographically successful percutaneous coronary intervention (PCI). Therefore, post-PCI physiologic assessment is necessary for judging the appropriateness of PCI, detecting the lesions that may benefit from additional PCI, and risk stratification after PCI. This review will focus on the current evidence for post-PCI physiologic assessment, how to interpret these findings, and the future perspectives of physiologic assessment after PCI.

Keywords: Fractional flow reserve; Non-hyperemic pressure ratio; Outcomes; Percutaneous coronary intervention.

Publication types

Review