Читать книгу Interventional Cardiology - Группа авторов - Страница 196

Physiological indices can provide an assessment of the success of coronary intervention. Both FFR or NHPR may be used to assess the hemodynamic improvement after a stent. Theoretically, complete removal of coronary stenoses should result in an iFR or FFR of 1.0. This is rarely the case as there is often milder focal or diffuse disease. A concern can be that treating a stenosis can “unmask” the physiological importance of residual stenoses due to “crosstalk” between stenoses. A further concern can be that PCI can cause acute microvascular dysfunction such that post‐PCI physiology may under‐estimate the significance of residual disease (by blunting response to adenosine). Furthermore, for resting indices, the process of balloon inflation or stent deployment generates relative ischemia and submaximal hyperemia that will cause a resting index to appear more ischemic. In practice, the time taken to remove the interventional balloons, flush the catheters, re‐administer intracoronary nitrates and prepare the pressure wire to make a measurement, there is stabilization of the physiological states that permit both iFR and FFR to be measured.