Physiological Assessment During Interventional Procedures

  • Nagendra Boopathy Senguttuvan
  • Anitha Rajamanickam
  • Annapoorna Kini


Angiography identifies minimal luminal diameter but does not calculate the minimal luminal area. The operator should keep in mind the limitations of angiography. A significant lesion may be missed due to its eccentric nature, location in a highly tortuous artery, ostial position, or length. In addition, moderate (50–70 %) lesions may be hemodynamically significant (see Fig. 4.1). Fractional flow reserve [FFR] provides objective evidence for functional significance. FFR-guided decision making provides better clinical outcomes when compared to angiography, and therefore every operator must be familiar with this technique.1


Myocardial Blood Flow Fractional Flow Reserve Microvascular Obstruction Distal Lesion Proximal Lesion 
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  1. 1.
    Tonino PA, De Bruyne B, Pijls NH. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention. N Engl J Med. 2009;360(3):213–24Google Scholar
  2. 2.
    De Bruyne B, Pijls NH, Kalesan B. Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease. N Engl J Med. 2012;367(11):991–1001.Google Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  1. 1.Department of Interventional CardiologyMount Sinai HospitalNew YorkUSA

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