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Coronary lesion physiological assessment and imaging

Coronary lesion physiological assessment and imaging

Coronary Lesion Physiological Assessment and Imaging in Broadway

Interventional cardiology requires a physiological assessment of coronary artery disease (CAD). For an accurate assessment of the hemodynamic implications of coronary artery stenosis, coronary angiography alone is insufficient. Imaging and coronary lesion physiological assessment are essential for the diagnosis and treatment of coronary artery disease. By assessing blood flow in lesions, physiological indicators such as fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) can help with treatment decision-making. There is a vast amount of anatomical data available for stent optimisation and lesion characterization through two different imaging methods: intravascular ultrasound (IVUS) and optical coherence tomography (OCT). With these methods, a customised strategy for coronary intervention can be implemented, focusing on lesions that significantly impact blood flow and ensuring precise drug administration, leading to better results.  

Consult our cardiologists if you need Coronary Lesion Physiological Assessment And Imaging in Kolkata.

FAQ's

In the following cases, a physiological examination of the coronary lesion is necessary:

  • Intermediate coronary stenosis: To assess the importance of moderately narrowed lesions

  • Multivessel disease: Assessing the hemodynamic effect of lesions helps determine the priority of treatment 

  • Uncertain angiographic outcomes: When the results of coronary angiography are unclear or contradictory

  • Evaluating non-obstructive lesions: To pinpoint lesions that produce ischemia even in the presence of only slight angiographic narrowing

  • Pre-intervention planning: Guiding decisions regarding angioplasty and stenting.

  • Post-intervention evaluation: Optimising stent placement and evaluating the efficacy of therapies

  • Chronic complete occlusions: Evaluate collateral flow and determine if revascularization is feasible

  • Patients with symptoms: Assessing the hemodynamic importance of lesions in individuals exhibiting symptoms of angina or ischemia

Inspection, palpation, and auscultation are all appropriate parts of a physical examination. Acute distress, peripheral oedema and jugular venous distention should all be looked for. When palpating, feel the heave and thrill of fluid. If peripheral oedema is present, its severity has to be assessed. 
 

Heart disease warning signs and symptoms, such as: 

  • Breathlessness 

  • Coughing 

  • Wheezing and chest pain

  • Foot, ankle, or leg swelling

  • Insufficient blood flow to the extremities

  • Exhaustion

  • Rapid or irregular heartbeat (palpitations) 

An imaging examination known as intravascular ultrasonography uses sound waves to create images of the heart and blood vessels from within the body. In the field of interventional cardiology, IVUS is predominantly utilised to assess stent expansion, assist in selecting the appropriate stent, examine plaque accumulation, examine lesion shape, and detect possible complications during medical procedures. IVUS can assist your doctor in clearly visualising your heart and blood vessels during some treatments, including angioplasty or atherectomy, or it can be used as a diagnostic tool for specific cardiac diseases. Using intravascular ultrasonography, your doctor may use:

  • Part of angioplasty and stenting

  • Precisely position a tiny stent to open an artery

  • Determine if a heart stent that is currently in place is clogged

  • Examine the artery plaque accumulation 

A new non-invasive imaging method called optical coherence tomography (OCT) is used in conjunction with coronary angiography to create intracoronary pictures with high resolution. OCT, which uses infrared light, bridges the gaps in traditional invasive coronary angiography by providing a thorough assessment of coronary atherosclerotic plaques. Interventional cardiologists employ OCT as an adjuvant technique for the following reasons:

  • Evaluation of obstructions caused by atherosclerotic plaques

  • Optimising and improving coronary angioplasty (stent placement

Physiological evaluation and coronary lesion imaging are subject to limitations:

  • Intrusive nature: Procedures including fractional flow reserve (FFR) and intravascular ultrasonography (IVUS) carry risks that can cause pain

  • Expensive: The cost and expertise needed for physiological assessments and imaging hinder accessibility

  • Interpretation challenges: Depending on the operator's experience, the results could be interpreted wrongly

  • Time-consuming: Radiation exposure and patient pain are increased when physiological assessments and imaging prolong the procedure

  • Comparing the evaluation of anatomy and function: If there is no correlation between imaging data and physiological relevance, several treatment options may be considered

  • Patient-related factors: The ever-changing nature of lesions and individual patients' characteristics can affect the precision of evaluations

While there is currently no known treatment for coronary heart disease, medication can effectively manage symptoms and reduce the likelihood of complications such as heart attacks. Among the treatments are:

  • Lifestyle adjustments, such as consistent exercise and refraining from smoking, 

  • Medications

  • Angioplasty is a procedure that fixes blocked arteries in the heart. Doctors use balloons and stents to open up the arteries.

  • Open surgery

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