Isquemia não se encontra com placas, mas com alterações de fluxo
Economic Evaluation of Fractional Flow Reserve–Guided Percutaneous Coronary Intervention in Patients With Multivessel Disease
The principal finding of this study is that performing PCI guided by FFR in patients with multivessel CAD saves healthcare resources and improves health outcomes at 1 year compared with a traditional strategy of angiographic guidance.
The presumed explanation for these results lies in the fact that the coronary angiogram, although our reference standard for diagnosing CAD, is a poor predictor of ischemia-producing lesions. For example, in the FAME trial, 65% of lesions with 50% to 70% diameter stenosis based on visual estimation were not responsible for an abnormal FFR (0.80), and 20% of lesions with a 71% to 90% diameter stenosis were not responsible for an abnormal FFR
Mesmo o óbvio precisa ser provado.
Todos sabíamos que…
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