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Why do we need physiology? • Limitations of coronary angiography • Limitations of noninvasive techniques – Often not performed – Can be inaccurate in multivessel disease – Generally “territory” specific, but not “vessel” specific – Can be “vessel” specific, but not “lesion” specific <strong>Stanford</strong>
Limitations of Noninvasive Imaging: 143 Patients with angiographically significant 3 vessel disease (> 70% diameter stenosis) Thallium Scan Finding % Patients No Defect 18% Single Vessel Pattern 36% Two Vessel Pattern 36% Three Vessel Pattern 10% Lima et al. J Am Coll Cardiol 2003;42:63-70 <strong>Stanford</strong>
Page 1 and 2: Coronary Physiology and Imaging Sum
Page 3 and 4: Why do we need physiology? • Limi
Page 5 and 6: Limitations of Angiography: Topol a
Page 7 and 8: Disconnect between Angiography and
Page 9: Disconnect between Angiography and
Page 13 and 14: Nuclear Perfusion Scan Stress Rest
Page 15 and 16: Long Area of Diffuse Disease Stanfo
Page 17 and 18: FFR/CFR/IMR of the RCA CFR IMR FFR
Page 19 and 20: Pullback in Circumflex Most of grad
Page 21 and 22: After “spot-stenting” proximal
Page 23 and 24: FFR after Stenting Pijls et al., Ci
Page 27 and 28: Drug-eluting stents: The “clot”
Page 29 and 30: Danger of Deferring PCI if FFR < 0.
Page 31 and 32: FFR vs. Angiography for Multivessel
Page 35 and 36: Cost Effectiveness of FFR: Clinical
Page 37 and 38: FFR strategy resulted in similar ou

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