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Editorial
March 21, 2018

A Perspective on Physiologic Assessment of Coronary Stenoses in SeriesMethods, Myths, and Best Practices?

Author Affiliations
  • 1Medicine, Veterans Administration Long Beach Health Care System, Long Beach, California
  • 2Medicine, University of California at Irvine
  • 3Cardiology, Veterans Administration Long Beach Health Care System, Long Beach, California
JAMA Cardiol. Published online March 21, 2018. doi:10.1001/jamacardio.2018.0239

2018 will mark the 41st anniversary of Andreas Gruentzig’s procedure, coronary balloon angioplasty, which evolved into the well-known methods of percutaneous coronary intervention (PCI). Percutaneous coronary intervention has favorably affected millions of patients, and for acute coronary syndromes, reduced death. Percutaneous coronary intervention has also been criticized for overuse because the decision to revascularize is often subjective, based on a visual assessment of the coronary angiographic stenosis. To improve on lesion selection beyond angiography, the ischemic potential of a coronary stenosis can be better assessed by translesional pressure indices. Gruentzig appreciated the limitations of angiography, even in 1977, and was prescient in equipping his balloon dilation catheter with a lumen to measure translesional pressure gradients and thus gauge the success of angioplasty.1

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