Angiography

Use of intravascular ultrasound (IVUS) in ambiguous angiograms

Introduction

Intravascular ultrasound (IVUS) can resolve abnormalities within the coronary artery to a degree that is not possible with angiography alone. With an axial resolution of 70-200 μm and lateral resolution of 200-400 μm, IVUS can provide information on arterial wall and luminal composition that can change clinical management decisions.

FFRCT for Complex Coronary Artery Disease Treatment Planning: New Opportunities

Coronary CTA has rapidly gone from a test with potential to be considered a first-line test for patients with stable chest pain.1 It provides robust ability to exclude atherosclerosis and coronary artery stenosis and more recently has been shown to inform and guide clinical treatment making in a fashion that enables a reduction in myocardial infarction when compared to traditional stress testing.2–5 Despite the growing clinical utility data and continued technology improvements, re

Performing and Interpreting Fractional Flow Reserve Measurements in Clinical Practice: An Expert Consensus Document

The invasive measurement of fractional flow reserve (FFR) can determine the haemodynamic relevance of coronary artery stenoses. Determination of FFR is recommended in coronary artery stenoses with a luminal diameter narrowing between 50 % and 90 % if no non-invasive proof of ischaemia is available.1 To measure the FFR of a given coronary lesion, a wire or a microcatheter equipped with a miniaturised pressure sensor is inserted into the coronary artery.

Hybrid Approach to Percutaneous Coronary Intervention to Treat Chronic Total Occlusions

The treatment of patients with clinically significant chronic total occlusions (CTOs) will become more frequent with an ageing population, an increasing number of patients undergoing transcatheter aortic valve implantation (TAVI) (20 % have co-existing coronary disease) and patients presenting following coronary artery bypass graft (CABG) failure where redo CABG is not attractive or not possible.

Fractional Flow Reserve Assessment of Coronary Artery Stenosis

Coronary artery disease (CAD) due to atherosclerosis is a major cause of morbidity and mortality. Early prevention of atherothrombotic disease with a healthy lifestyle (diet, exercise, optimal body weight and no smoking) is considered the best method of “treating” CAD, although increasing age remains associated with significant cardiovascular events.

Drug-coated Balloon-only Angioplasty for Native Coronary Disease Instead of Stents

Percutaneous coronary interventional techniques and devices have evolved enormously since Gruntzig performed his first coronary angioplasty in 1977. 1 It is now the norm to treat patients with both acute coronary syndrome and stable coronary artery disease with drug-eluting stents. We intend to review the evidence and discuss potential benefits of drug-coated balloon-only angioplasty.