Search results for "Severe stenosis"
showing 4 items of 4 documents
Quantitative Coronary Angiography and Digital Densitometric Perfusion Measurements?How to Assess the Success of Intracoronary Balloon Dilatation
1988
Densitometric evaluation of digital subtraction angiocardiograms allows the assessment of local myocardial perfusion before and after pharmacological stimulation of coronary flow reserve during the catheterization procedure. This report deals with a case of a severe stenosis of the left coronary artery in which PTCA was regarded successful based on an appropriate increase in luminal diameter while an intima and media dissection at the dilatation site was documented. The perfusion measurements, however, pointed out a clear impairment of poststenotic myocardial perfusion after PTCA.
When the Pd/Pa Is Already Significant: A “Quick and Clean” FFR
2016
The assessment of FFR for a single stenosis may also be rapid and not require hyperemia if the Pd/Pa gradient already reaches significance before the vasodilator is administered. In this case the resting Pd/Pa was 0.45, demonstrating that the stenosis was relevant even before hyperemia was achieved.
Multiple Lesions, Multiple Measures
2016
This case describes the assessment of FFR in the case of tandem intermediate lesions in the proximal and mid LAD. Hyperemia was induced with intravenous (IV) infusion of Adenosine, which allows pullback measurements. First, with the wire placed distal in the vessel, FFR provides information on whether the sum of the two stenoses causes ischemia. Thereafter, during pullback, the most severe stenosis can be identified as the most relevant pressure drop. Finally, a re-evaluation of FFR is important after PCI: after the first stenosis is treated, the degree of hyperemia achievable will be larger, thus unmasking the relevance of the second one.
Contrast-Induced Hyperemia and FFR: Slightly Slower but still “Quick and Clean”
2016
Slightly more complex than the previous one, a quick way to induce hyperemia is to inject a contrast bolus. Although the degree of hyperemia reached this way is not as large as with vasodilators, this maneuver can still allow unmasking a gradient.