Value of intracoronary Doppler for guiding percutaneous interventions
(De waarde van intracoronaire Doppler bij percutane interventies)
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Following the rapid developments in computer software directed towards the anatomical assessment of coronary arteries by quantitative coronary angiography (QCA), interventional cardiologist felt that the anatomical information obtained was sufficient for clinical decision-making. However, further down the line, it became clear that QCA presented some limitations especially in patients with diffuse coronary artery atherosclerosis. In addition, the presence of haziness at the dilated area precluded an accurate estimate of the acute angioplasty results. The latter was further supporter by a lack of correlation observed between the QCA and coronary physiological data following an intervention. Thanks to the pioneer work of Lance Gould and his team, who established the relationship between the coronary blood flow resistance and the severity of the condnit obstruction, the understanding of coronary physiology and its assessment had rapidly evolved. Furthermore, technical improvements have allowed the development of miniaturized pressure and Doppler transducers, mounted on 0.014-in. guidewire, These small devices did not exert a significant effect in coronary fluid dynamics, which permitted an accurate physiological evaluation of percutaneous interventions at the catheterization laboratory.
- balloon angioplasty
- flow velocity reserve
- flow reserve