title: The Instantaneous wave-Free Ratio (iFR) pullback: a novel innovation using baseline physiology to optimise coronary angioplasty in tandem lesions.
abstract: Coronary intervention is increasingly performed in complex disease with tandem and diffuse disease. Pressure wires enable detailed assessment of the physiological significance of a stenosis but in the presence of tandem disease, predicting the impact of a stenting a given stenosis can be difficult and is impeded by flow interaction between stenoses under hyperemia. In this review, we consider the physiological difficulties posed by flow interaction under hyperemia and consider alternative approaches such as assessment under baseline conditions. Specifically we consider the potential value of the iFR-Pullback approach and its capacity to enable Virtual-PCI, which may assist in planning intervention.
authors.affiliation: Imperial College London, London, UK.
authors.forename: Sukhjinder S
authors.initials: SS
authors.lastname: Nijjer
authors.affiliation: Imperial College London, London, UK.
authors.forename: Sayan
authors.initials: S
authors.lastname: Sen
authors.affiliation: Imperial College London, London, UK.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Petraco
authors.affiliation: Imperial College London, London, UK.
authors.forename: Jamil
authors.initials: J
authors.lastname: Mayet
authors.affiliation: Imperial College London, London, UK.
authors.forename: Darrel P
authors.initials: DP
authors.lastname: Francis
authors.affiliation: Imperial College London, London, UK. Electronic address: justin.davies@imperial.ac.uk.
authors.forename: Justin E R
authors.initials: JE
authors.lastname: Davies
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods; D017023:Coronary Angiography / Q000379:methods; D023921:Coronary Stenosis / Q000175:diagnosis / Q000628:therapy*; D003331:Coronary Vessels / Q000601:surgery*; D053805:Fractional Flow Reserve, Myocardial / Q000502:physiology*; D006801:Humans; D009204:Myocardial Revascularization / Q000379:methods
keywords: Coronary physiology; Instantaneous wave-free ratio; Percutaneous coronary intervention; Pressure wire; Serial lesions; Tandem lesions