12.1 Manual of PCI - Coronary physiology

Coronary physiology is performed in order to: (a) assess the hemodynamic significance of native coronary lesion and determine the need for PCI; and (b) to assess whether an optimal result was achieved after PCI.
Both hyperemic (usually adenosine FFR) and non-hyperemic indices (such as iFR, dPR, RFR) can be used, with non-hyperemic indices used more commonly as they are easier to perform.
Coronary physiologic assessment is performed in 8 steps, as follows:
1. Flush + zero pressure wire
2. Insert pressure to tip of guide
3. Remove introducer, flush guide with NS, equalize pressures
4. Advance pressure wire distal to the target lesion
5. Measure resting physiologic index
6. Measure hyperemic FFR (if needed)
7. Pullback
8. Check for drift

[@1kamais]

Great educational clip. I really appreciate you Dr. Brilakis. I’ve learnt a great deal from you.

[@shangz0216]

Thanks for your educative sharing.

[@matheuscsmed]

Thank you, Matheus Silva

[@areenal-taie6836]

Excellent learning video, thank you very much

[@hazemalbareda1872]

thanks a lot , great short ,conclusive presentation

[@tom11298]

excellent presentation

[@MrAymano1]

Thanks!!

[@praveenalane4331]

Thank you professor

[@deriarara376]

thank you so much

[@llacielona]

Thank you so much for the effort that you put and all the great presentations! There are some cases when iFR ist >0,9 at normal conditions, but falls below 0,9 meaning it becomes pathologic after contrast injection. What do you do with those cases, particularly if patients do have angina, put a stent or leave them alone?

[@salahuddinsalahuddin3210]

Thanks.

[@salahuddinsalahuddin3210]

Thank you. Just one additional question: what kind of guide catheter can we use? With side holes, without or both?

[@herminingsih66]

thank you professor for such a clear and very informative educational video