Current Trends and Perspectives of Pressure Wire-Based Coronary Artery Bypass Grafting
Fractional flow reserve (FFR) has been well validated as a modality for evaluating myocardial ischemia, demonstrating the superiority of FFR-guided percutaneous coronary intervention (PCI) over conventional angiography-guided PCI. As a result, the strategy for coronary artery bypass grafting (CABG)...
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MDPI AG
2025-01-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/12/1/16 |
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| author | Yoshiyuki Takami Atsuo Maekawa Koji Yamana Kiyotoshi Akita Kentaro Amano Wakana Niwa Kazuki Matsuhashi Yasushi Takagi |
| author_facet | Yoshiyuki Takami Atsuo Maekawa Koji Yamana Kiyotoshi Akita Kentaro Amano Wakana Niwa Kazuki Matsuhashi Yasushi Takagi |
| author_sort | Yoshiyuki Takami |
| collection | DOAJ |
| description | Fractional flow reserve (FFR) has been well validated as a modality for evaluating myocardial ischemia, demonstrating the superiority of FFR-guided percutaneous coronary intervention (PCI) over conventional angiography-guided PCI. As a result, the strategy for coronary artery bypass grafting (CABG) is shifting toward FFR guidance. However, the advantage of FFR-guided CABG over angiography-guided CABG remains unclear. While FFR-guided CABG can help avoid unnecessary grafting in cases of moderate stenosis, it may also carry the risk of incomplete revascularization. The limited use of FFR due to the need for hyperemia has led to the development of non-hyperemic pressure ratios (NHPRs). NHPR pullback provides trans-stenotic pressure gradients, which may offer valuable insights for CABG strategies. Recently, computed tomographic coronary angiography (CTCA) has emerged as a non-invasive modality that provides accurate data on lesion length, diameter, minimum lumen area, percentage stenosis, and the volume and distribution of high-risk plaques. With the introduction of FFR-CT, CTCA is now highly anticipated to provide both functional evaluation (of myocardial ischemia) via FFR-CT and anatomical information through serial quantitative assessment. Beyond the diagnostic phase, CTCA, augmented by automatic artificial intelligence, holds great potential for guiding therapeutic interventions in the future. |
| format | Article |
| id | doaj-art-051bf1ae07b84ffab46c72352a151667 |
| institution | Kabale University |
| issn | 2308-3425 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj-art-051bf1ae07b84ffab46c72352a1516672025-01-24T13:35:59ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252025-01-011211610.3390/jcdd12010016Current Trends and Perspectives of Pressure Wire-Based Coronary Artery Bypass GraftingYoshiyuki Takami0Atsuo Maekawa1Koji Yamana2Kiyotoshi Akita3Kentaro Amano4Wakana Niwa5Kazuki Matsuhashi6Yasushi Takagi7Department of Cardiovascular Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake 470-1192, Aichi, JapanDepartment of Cardiovascular Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake 470-1192, Aichi, JapanDepartment of Cardiovascular Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake 470-1192, Aichi, JapanDepartment of Cardiovascular Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake 470-1192, Aichi, JapanDepartment of Cardiovascular Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake 470-1192, Aichi, JapanDepartment of Cardiovascular Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake 470-1192, Aichi, JapanDepartment of Cardiovascular Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake 470-1192, Aichi, JapanDepartment of Cardiovascular Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake 470-1192, Aichi, JapanFractional flow reserve (FFR) has been well validated as a modality for evaluating myocardial ischemia, demonstrating the superiority of FFR-guided percutaneous coronary intervention (PCI) over conventional angiography-guided PCI. As a result, the strategy for coronary artery bypass grafting (CABG) is shifting toward FFR guidance. However, the advantage of FFR-guided CABG over angiography-guided CABG remains unclear. While FFR-guided CABG can help avoid unnecessary grafting in cases of moderate stenosis, it may also carry the risk of incomplete revascularization. The limited use of FFR due to the need for hyperemia has led to the development of non-hyperemic pressure ratios (NHPRs). NHPR pullback provides trans-stenotic pressure gradients, which may offer valuable insights for CABG strategies. Recently, computed tomographic coronary angiography (CTCA) has emerged as a non-invasive modality that provides accurate data on lesion length, diameter, minimum lumen area, percentage stenosis, and the volume and distribution of high-risk plaques. With the introduction of FFR-CT, CTCA is now highly anticipated to provide both functional evaluation (of myocardial ischemia) via FFR-CT and anatomical information through serial quantitative assessment. Beyond the diagnostic phase, CTCA, augmented by automatic artificial intelligence, holds great potential for guiding therapeutic interventions in the future.https://www.mdpi.com/2308-3425/12/1/16coronary artery bypass graftingfractional flow reservenon-hyperemic pressure ratioscoronary computed tomography angiography |
| spellingShingle | Yoshiyuki Takami Atsuo Maekawa Koji Yamana Kiyotoshi Akita Kentaro Amano Wakana Niwa Kazuki Matsuhashi Yasushi Takagi Current Trends and Perspectives of Pressure Wire-Based Coronary Artery Bypass Grafting Journal of Cardiovascular Development and Disease coronary artery bypass grafting fractional flow reserve non-hyperemic pressure ratios coronary computed tomography angiography |
| title | Current Trends and Perspectives of Pressure Wire-Based Coronary Artery Bypass Grafting |
| title_full | Current Trends and Perspectives of Pressure Wire-Based Coronary Artery Bypass Grafting |
| title_fullStr | Current Trends and Perspectives of Pressure Wire-Based Coronary Artery Bypass Grafting |
| title_full_unstemmed | Current Trends and Perspectives of Pressure Wire-Based Coronary Artery Bypass Grafting |
| title_short | Current Trends and Perspectives of Pressure Wire-Based Coronary Artery Bypass Grafting |
| title_sort | current trends and perspectives of pressure wire based coronary artery bypass grafting |
| topic | coronary artery bypass grafting fractional flow reserve non-hyperemic pressure ratios coronary computed tomography angiography |
| url | https://www.mdpi.com/2308-3425/12/1/16 |
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