19 May 2023
Multivessel disease PCI guided by physiology and intracoronary imaging - LIVE case
Physiology- and IVUS-guided PCI for 3-vessel disease
Summary
A 68-year-old non-diabetic male patient presented with recent exertional chest pain and good LV function. Baseline angiography revealed severe stenosis of the proximal RCA, mid-stenosis of the proximal and mid-CX, and mid-stenosis of the proximal and mid-LAD.
Physiology revealed significant stenosis of proximal CX and proximal LAD.
IVUS was performed and the 3 vessels were treated with 3 long stents after predilatation.
The result was perfect on IVUS for all 3 vessels: FFR was 0.93 for RCA, 1.0 for CX, 0.82 for distal LAD, and 0.99 for proximal LAD.
LIVE Case from National University Heart Centre, Singapore
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Key moments
- 17:28-22:24 - µFR and QFR analysis of the 3 vessels
- 23:15 - 24:48 - FFR of the 3 vessels before PCI
- 36:50 - 46:36 - IVUS and FFR post PCI on CX
- 01:03:16 - 01:13:05 - IVUS and FFR post PCI on LAD
Keywords: Multivessel disease (MVD), µFR, QFR, FFR, IVUS
Learning Objectives
- To learn how to use the physiology to evaluate the impact of the different lesions in patients with multivessel disease
- To learn about different available modalities for functional assessment (angio based and wire based)
- To understand how to use imaging to optimise stenting in patients with multivessel disease
