Abstract

Complementary imaging methods and functional assessment of vascular lesions arises from the limitations of coronary angiography in certain scenes. We will talk about the use given to iFR, IVUS and SyncVision in a 75-year-old patient diagnosed with AMI who, after having undergone primary culprit vessel angioplasty, re-enters to the hemodynamic room for assessment of intermediate tandem injury in the anterior descending artery in proximal and medial segment. The iFR values were 0.68 distal, 0.94 between the two lesion and 0.99 proximal. IVUS and SyncVision showed an irregular and irregular calcified plaque with a luminal area of 3.5 mm² on distal injury. We decided to treat only the distal lesion with a pharmacological stent (Microport Firehawk 3.0 x 13 mm) at 12 atm. After angioplasty, the iFR control had a value of 0.93 distal to the stent. IVUS showed stent under expansion. Post dilation was performed with a 3.5x8mm balloon with successful results. These complementary methods allowed us to carry out a focused therapy specifically to the segment that presented a hemodynamically significant lesion, without compromising the remaining segments or collateral branches, thus reducing the extension covered by angioplasty and avoiding the possible need to carry out therapy in an area that involves the origin of a large caliber diagonal branch.

Keywords: Coronary Artery Disease; Intravascular Ultrasonography; Percutaneous Coronary Intervention; IVUS; IFR; Instantaneous Wave Free Ratio; SyncVision; Hemodynamics; Coronary Disease; Myocardial Infarction; Middle Lesion

References

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Citation

Citation: Visconti Mariano., et al. “IFR and IVUS on a Middle Lesion - Case Report".Acta Scientific Medical Sciences 4.10 (2020): 33-35.

Copyright

Copyright: © 2020 Visconti Mariano.,et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.