Search results for "fractional flow"

Computational modeling of bicuspid aortopathy: Towards personalized risk strategies.

2019

This paper describes current advances on the application of in-silico for the understanding of bicuspid aortopathy and future perspectives of this technology on routine clinical care. This includes the impact that artificial intelligence can provide to develop computer-based clinical decision support system and that wearable sensors can offer to remotely monitor high-risk bicuspid aortic valve (BAV) patients. First, we discussed the benefit of computational modeling by providing tangible examples of in-silico software products based on computational fluid-dynamic (CFD) and finite-element method (FEM) that are currently transforming the way we diagnose and treat cardiovascular diseases. Then…

Usefulness of concomitant myoglobin and troponin elevation as a biochemical marker of mortality in non–ST-segment elevation acute coronary syndromes

2003

Koolen JJ. Measurement of fractional flow reserve to assess the functional severity of coronary-artery stenoses. N Engl J Med 1996;334:1703–1708. 2. Senior R, Kaul S, Soman P, Lahiri A. Power-Doppler contrast echocardiography—a new technique for Assessing myocardial perfusion. Am Heart J 2000; 139:245–251. 3. Picano E, Parodi O, Lattanzi F, Sambuceti G, Andrade MJ, Marzullo P, Giorgetti A, Salvadori P, Marzilli M, Distante A. Assessment of anatomic and physiological severity of single-vessel coronary artery lesions by dipyridamole echocardiography. Comparison with positron emission tomography and quantitative arteriography. Circulation 1994;89:753–761. 4. Jayaweera AR, Wei K, Coggins M, Bin…

Transmural myocardial ischaemia complicating recovery after dobutamine-atropine stress echocardiography in patients with non-significant coronary art…

2011

In the proposed selection of cases, traditional imaging is integrated with contemporary diagnostic tools available in the cath-lab to navigate the potential mechanisms underlying a very rare complication occurring in the recovery phase of dobutamine-atropine stress echocardiography. The data, collected in a time frame of nearly 15 years, provide interesting elements to possibly evolve from speculative considerations to plausible confirmation of the candidate pathophysiological mechanism mediating the occurrence of transmural myocardial ischaemia after beta-blockers administration.

Diagnosis and management of silent coronary ischemia in patients undergoing carotid endarterectomy.

2021

Abstract Background Coronary artery disease is the primary cause of death in patients with carotid artery disease and silent ischemia is a marker for adverse coronary events. A new noninvasive cardiac diagnostic test, coronary computed tomography-derived fractional flow reserve (FFRCT) can reliably identify ischemia-producing coronary stenosis in patients with coronary artery disease and help to select patients for coronary revascularization. The purpose of this study is to determine the prevalence of silent coronary ischemia in patients undergoing carotid endarterectomy (CEA) and to evaluate the usefulness of FFRCT in selecting patients for coronary revascularization to decrease cardiac ev…

Occlusion of the abdominal aorta during coronary angiography with fractional flow reserve due to migration of the left ventricle thrombus in a patien…

2019

Myocardial Perfusion and Fractional Flow Reserve

2013

Myocardial CT perfusion imaging is a rapidly evolving technology that allows assessment of the functional significance of potentially obstructive coronary stenosis. The opportunity for quantification of myocardial perfusion is the greatest potential advantage of CT compared with other perfusion techniques. On the other hand, fractional flow reserve during coronary angiography provides a functional assessment of coronary lesions identified with this modality. Recently, a non-invasive method for estimating fractional flow reserve, based on coronary CT angiography has been introduced. Nevertheless, at present neither CT perfusion nor CT FFR are ready for widespread use in clinical routine.

Subsecond pore‐scale displacement processes and relaxation dynamics in multiphase flow

2014

With recent advances at X‐ray microcomputed tomography (μCT) synchrotron beam lines, it is now possible to study pore‐scale flow in porous rock under dynamic flow conditions. The collection of four‐dimensional data allows for the direct 3‐D visualization of fluid‐fluid displacement in porous rock as a function of time. However, even state‐of‐the‐art fast‐μCT scans require between one and a few seconds to complete and the much faster fluid movement occurring during that time interval is manifested as imaging artifacts in the reconstructed 3‐D volume. We present an approach to analyze the 2‐D radiograph data collected during fast‐μCT to study the pore‐scale displacement dynamics on the time s…

Setting the Stage: How to Perform Intracoronary Pressure Measurements

2016

FFR has become an established technology, and alternative approaches, like the instantaneous flow reserve (iFR), are currently being validated. FFR and iFR are generally easy to perform and interpret, but, as with all other technologies, oversimplification also carries risks. In the first chapter of this book, we present the basics of FFR measurements, including basic tips and tricks, and a short introduction to the devices available on the market.

Impacto Clínico e Custo-Efetividade da FFR em Comparação à Angiografia em Pacientes com Doenças Multiarteriais Submetidos à ICP

2018

Abstract Background: In multivessel disease patients with moderate stenosis, fractional flow reserve (FFR) allows the analysis of the lesions and guides treatment, and could contribute to the cost-effectiveness (CE) of non-pharmacological stents (NPS). Objectives: To evaluate CE and clinical impact of FFR-guided versus angiography-guided angioplasty (ANGIO) in multivessel patients using NPS. Methods: Multivessel disease patients were prospectively randomized to FFR or ANGIO groups during a 5 year-period and followed for < 12 months. Outcomes measures were major adverse cardiac events (MACE), restenosis and CE. Results: We studied 69 patients, 47 (68.1%) men, aged 62.0 ± 9.0 years, 34 (49.2%…

Clinical outcomes of fractional flow reserve by computed tomographic angiography-guided diagnostic strategies vs. usual care in patients with suspect…

2015

International audience; AIMS: In symptomatic patients with suspected coronary artery disease (CAD), computed tomographic angiography (CTA) improves patient selection for invasive coronary angiography (ICA) compared with functional testing. The impact of measuring fractional flow reserve by CTA (FFRCT) is unknown. METHODS AND RESULTS: At 11 sites, 584 patients with new onset chest pain were prospectively assigned to receive either usual testing (n = 287) or CTA/FFR(CT) (n = 297). Test interpretation and care decisions were made by the clinical care team. The primary endpoint was the percentage of those with planned ICA in whom no significant obstructive CAD (no stenosis \textgreater/=50% by …