FFR檢測(cè)操作及應(yīng)用指導(dǎo)

1、.,1,冠脈壓力測(cè)量46: 633-7,分叉病變,Koo的研究結(jié)論：大多數(shù)可疑的主干分叉病變?cè)谥萌胫Ъ芎蟛⒉](méi)有功能性的意義（大于74%）。,FFR的應(yīng)用 6,.,38,Ostial Diagonal,Proximal LAD,.,39,分叉病變,評(píng)估主枝 評(píng)估側(cè)枝 Kissing的效果,.,40,測(cè)量所有可疑的病變 使用持續(xù)時(shí)間長(zhǎng)的血管擴(kuò)張方法（IV） 壓力回撤的時(shí)間 FFR小于0.75的狹窄處放置支架,多支病變,FFR的應(yīng)用 7,.,41,RCA,在哪個(gè)位置進(jìn)行介入？,FFR的應(yīng)用 8,.,42,RCA,FFR = 0.94 0.75,FFR = 0.89 0.75,FFR = 0.90

2、0.75,FFR的應(yīng)用 9,.,43,RCA,FFR = 0.41 0.75,FFR的應(yīng)用 10,.,44,FFR = 0.67 0.75,After balloon inflation 3.0 balloon 12 atm (mid-RCA),FFR的應(yīng)用 11,.,45,After stent 3.5 mm (mid-RCA),FFR = 0.80Not optimal post stent result,FFR的應(yīng)用 12,.,46,Stent 3.5 mm (mid-RCA) + Stent 3.5 mm (prox-RCA),FFR = 0.94Optimal post stent

3、result,FFR的應(yīng)用 13,.,47,1.0,0.80,inducibleischemia,diagnosticprocedure,no ischemia,決策,0.75,FFR的應(yīng)用 14,.,48,After stent implantation FFR 0.94 = Optimum stent result,After balloon angioplasty FFR 0.90 = Excellent result,interventionalsuccess,optimal,suboptimal,no success,1.0,0.75,0.94,評(píng)估介入治療的效果,FFR的應(yīng)用 15

4、,.,49,0.96 4,9% 0.91 - 0.95 6,2% 0.86 - 0.9016,2% 0.81 - 0.8522,2% 0.75 - 0.8029,5%,FFR after stent* deployment,Restenosis frequency(TVR) 6 months follow-up,Coronary Pressure Measurement After Stenting Predicts Adverse Events at Follow-Up. Nico Pijls et al, Catharina Hospital, Eindhoven, The Netherlands. Circulation, 2002; 105: 2950-2954,* Bare metal stents,評(píng)估介入治療的效果,(TVR:Target Vessel Revascularization),FFR的應(yīng)用 16,.,50,Number of patients,% re-intervention or event at 6 months,Pijls, TCT 2001.,多中心置放支架后FFR測(cè)量登記 750名患者，15家醫(yī)院，8