Value of intracoronary Doppler for guiding percutaneous interventions
2001
textabstractFollowing the rapid developments in computer software directed towards the
anatomical assessment of coronary arteries by quantitative coronary angiography
(QCA), interventional cardiologist felt that the anatomical information obtained was
sufficient for clinical decision-making. However, further down the line, it became
clear that QCA presented some limitations especially in patients with diffuse coronary
artery atherosclerosis. In addition, the presence of haziness at the dilated area
precluded an accurate estimate of the acute angioplasty results. The latter was further
supporter by a lack of correlation observed between the QCA and coronary
physiological data following an intervention.
Thanks to the pioneer work of Lance Gould and his team, who established the
relationship between the coronary blood flow resistance and the severity of the
condnit obstruction, the understanding of coronary physiology and its assessment had
rapidly evolved. Furthermore, technical improvements have allowed the development
of miniaturized pressure and Doppler transducers, mounted on 0.014-in. guidewire,
These small devices did not exert a significant effect in coronary fluid dynamics,
which permitted an accurate physiological evaluation of percutaneous interventions at
the catheterization laboratory.
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