Periprocedural anatomical and physiological assessment of myocardial revascularisation

The goal of coronary revascularisation, whether via stenting or bypass grafting, is not merely to address coronary artery obstructions but also to improve clinical outcomes. Functional assessment of coronary stenoses has become the standard of care to evaluate the significance of coronary flow-limitation, and to justify revascularisation in contemporary practice. Imaging- derived physiological assessment based on invasive coronary angiography (ICA) or coronary computed tomographic angiography (CCTA) is an alternative to wire-based pressure measurements, and offers the benefits of being less invasive, more cost-effective, and having a shorter procedure time. In patients with complex coronary artery disease (CAD), the decision by the Heart Team between either percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) is aided using an objective risk model such as the SYNTAX Score Ⅱ 2020, which facilitates an individual assessment of the short- and long-term risk benefit with each treatment modality (1). Optimal medical therapy after revascularisation is associated with long-term survival benefit (2).

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University of Galway

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Attribution-NonCommercial-NoDerivatives 4.0 International

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University of Galway Theses (PhD Theses)