Article preview from Medtech Insight - April 01, 2011
Clinical advancements in the cardiac catheterization lab most often occur in fits and starts, rarely in smooth progressions. Momentous developments like the percutaneous transluminal coronary angioplasty catheter, the bare metal stent, and then the drug-eluting stent shook both the profession and the industry.
Article preview from Medtech Insight - April 01, 2011
Clinical advancements in the cardiac catheterization lab most often occur in fits and starts, rarely in smooth progressions. Momentous developments like the percutaneous transluminal coronary angioplasty (PTCA) catheter, the bare metal stent, and then the drug-eluting stent truly shook both the profession and the industry. Refinements usually follow. More recently, following positive results from a landmark clinical study, measurement of fractional flow reserve (FFR), a guidewire-based tactical advance, is being utilized in greater numbers by interventional cardiologists as a combined refinement and development that shows great promise for both improving patient outcomes and lowering cost, all with few known negative consequences.
FFR is a unique tool that assesses the severity of a coronary artery blockage by comparing blood flow at the distal and proximal ends of the lesion. The test provides a blood flow index that helps cardiologists differentiate with relative ease between high-risk arterial lesions that can lead to ischemia and more stable lesions that are far less likely to cause a serious blockage. This critical evaluation is one that cannot always be made through traditional angiography, for years the key determinant of the need for percutaneous coronary intervention (PCI) procedures such as stenting.
Perhaps most important, FFR may enable cardiologists to determine with a much higher degree of certainty whether stenting is really necessary or whether certain lower risk patients would be better managed with far less invasive and less expensive options, such as medical therapy. Such an advance would help address recent, widely publicized concerns about physicians accused of implanting stents in patients unnecessarily.
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