The contemporary role of coronary physiology methods and intravascular imaging in percutaneous treatment of coronary artery disease
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https://orcid.org/0000-0002-8133-9318
Abstract
Ischemic heart disease (IHD) remains the leading pathology among cardiovascular diseases, showing a trend of increasing morbidity and a younger age of patients. The incidence of IHD grows every year, with patients becoming younger and mortality rates rising. Without timely diagnosis and effective treatment, this can lead to catastrophic consequences. IHD occurs due to an imbalance between the heart muscle’s oxygen demand and its delivery through the coronary blood flow. Timely diagnosis and effective treatment of IHD are critically important to prevent catastrophic events such as myocardial infarction or sudden cardiac death. The main task is to detect atherosclerotic lesions and determine their severity. Modern visualization methods, such as intravascular ultrasound (IVUS) and fractional flow reserve (FFR), are highly reliable invasive methods for assessing the potential for ischemic damage, with an accuracy of over 90 %. These methods are especially useful for evaluating intermediate coronary lesions in stable ischemic heart disease. Therefore, timely diagnosis and the use of modern methods for assessing atherosclerotic lesions are key to effective treatment of IHD and preventing serious complications. This article discusses the significance of visualization methods, supported by international multicenter studies such as DEFER, FAME-1, FAME-2, and FAME-3. In the presented clinical case of a patient with intermediate coronary artery stenosis, an evaluation was performed using fractional flow reserve (FFR) and intravascular ultrasound (IVUS). FFR helps determine the functional significance of a stenosis by measuring pressure before and after the narrowing, which assists in deciding whether revascularization is necessary. IVUS provides detailed visualization of the vessel’s internal structure, allowing the assessment of plaque morphology and the degree of stenosis.
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