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Journal of Nuclear Cardiology

, Volume 25, Issue 3, pp 860–871 | Cite as

Invasive assessment of coronary artery disease

  • Stylianos A. Pyxaras
  • William Wijns
  • Johan H. C. Reiber
  • Jeroen J. Bax
Review Article

Abstract

Coronary artery disease is associated to high mortality and morbidity rates and an accurate diagnostic assessment during heart catheterization has a fundamental role in prognostic stratification and treatment choices. Coronary angiography has been integrated by intravascular imaging modalities, namely intravascular ultrasound and optical coherence tomography, which allow the precise quantification of the atherosclerotic burden of coronary arteries. The hemodynamic relevance of a given coronary stenosis can be assessed using stress or resting indexes: fractional flow reserve and instantaneous wave-free ratio are both coronary flow surrogates, used to guide percutaneous coronary interventions. This review summarizes the current state-of-the-art of invasive diagnostic methods during heart catheterization and highlights the potential role that an integration of anatomical and functional information enables.

Keywords

Coronary angiography intravascular ultrasound optical coherence tomography fractional flow reserve 

Abbreviations

CAD

Coronary artery disease

CTO

Chronic total occlusion

FFR

Fractional flow reserve

iFR

Instantaneous wave-free ratio

IMR

Index of microvascular resistance

IVUS

Intravascular ultrasound

LM

Left main coronary artery

OCT

Optical coherence tomography

PCI

Percutaneous coronary intervention

QCA

Quantitative coronary angiography

Notes

Disclosures

The department of cardiology of the Leiden University Medical Center, The Netherlands, has received unrestricted research grants from Biotronik, Medtronic, Boston Scientific and Edwards Lifescience. Johan H. C. Reiber is the CEO of Medis Medical Imaging Systems bv, and has a part-time appointment at LUMC as Professor of Medical Imaging. William Wijns is non-executive board member and shareholder of Argonauts Partners, Celyad and Genae Inc. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Supplementary material

12350_2017_1050_MOESM1_ESM.pptx (922 kb)
Supplementary material 1 (PPTX 922 kb)

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Copyright information

© American Society of Nuclear Cardiology 2017

Authors and Affiliations

  • Stylianos A. Pyxaras
    • 1
  • William Wijns
    • 2
  • Johan H. C. Reiber
    • 3
  • Jeroen J. Bax
    • 4
  1. 1.Cardiology DepartmentCoburg-ClinicCoburgGermany
  2. 2.The Lambe Institute for Translational Medicine and CuramNational University of Ireland, Galway and Saolta University Healthcare GroupGalwayIreland
  3. 3.Division of Image Processing, Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
  4. 4.Department of CardiologyLeiden University Medical CenterLeidenThe Netherlands

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