The Future of Coronary Imaging and Physiology-Discussion: Physiology Pathway

Video Transcription

Yeah, we're going to take questions right now. So go ahead and stay there. So Alyssa, do you mind commenting on his pathway? Is this the way you would do physiology in your lab?  I do IFR prior to FFR in every lesion. And I try to give peripheral adenosine. And then additionally, sometimes it's hard to get the buy-in from the staff to do the post-IFR.  But if there's a second lesion that I'm not sure I need to treat, then I'll do it in the middle. Sort of treat the distal and then figure out afterwards. Evan?  I pretty much do the exact same algorithm. The only thing I'd say with if the IFR is negative or resting index is negative, I think it depends what the value is.  If it's 1.0, 0.99, 0.98, depending on the clinical situation, you don't need to always do FFR. If it's anywhere around the cut point,  if it's discordant with the clinical presentation, I think it's of significant importance to go ahead with FFR. So I thought I wouldn't actually comment on that specifically.  I think that just for this session on how to do it and do it, how to do it and how to do it differently, the group who came to this breakfast this morning probably does it.  And that the group who really needs to hear this is not here this morning. So I think that me telling you how to do it is irrelevant.  But I think the key is to measure it before and then to measure it afterward. And we were talking earlier that you may find nothing in a few cases.  But one out of five, you're going to find something.

Video Summary

In this video, a discussion is taking place about the methodology for conducting physiology testing in a lab. Alyssa mentions that she conducts IFR prior to FFR in every lesion and tries to administer peripheral adenosine. Getting buy-in from staff for post-IFR can be challenging, but if there's a second lesion that doesn't require treatment, she performs it in the middle and determines the next steps afterward. Evan shares a similar algorithm, noting that if the resting index is negative, the decision to proceed with FFR depends on the value and clinical situation. The importance of measuring before and after is emphasized, as something significant is likely found in one out of five cases. The video credits are not provided.

Keywords

physiology testing

IFR

FFR

peripheral adenosine

resting index