Coronary Vascular (DYS) Function and Invasive Physiology Assessment: Insights into Bolus and Continuous Thermodilution Methods.

A considerable number of patients with angina or myocardial ischemia have no significant coronary artery disease on invasive angiography. In recent years, several steps towards a better comprehension of the pathophysiology of these conditions, angina or ischemia with non-obstructive coronary arteries (ANOCA/INOCA), have been made. Nevertheless, several gaps in knowledge still remain. This review is intended to provide a comprehensive overview of ANOCA and INOCA, with a particular focus on pathophysiology, recent diagnostic innovations, gaps in knowledge and treatment modalities.

Long-term invasive follow-up of bioresorbable vascular scaffold: Optical Coherence Tomography assessment of jailed side branches.

BACKGROUND: Little is known about the long term development of the tissue bridges covering the struts of bioresorbable vascular scaffold (BVS) at the side branches (SB) ostium. This study aims at assessing the resorption process of jailed SB after BVS implantation. METHODS: We performed both Optical Coherence Tomography (OCT) and Intravascular Ultrasound (IVUS) analysis of 7 patients enrolled in the ABSORB Cohort B trial at our center. Orifice SB area and mean thickness of tissue bridge covering SB were calculated from 2D assessment. The number of SB orifice compartments separated by BRS struts was analysed by using 3D OCT reconstruction. RESULTS: At 5years follow-up, no struts could be identified. Between 3 and 5years, both lesion-level and cross section-level OCT findings showed a significant increase in Mean lumen area (MLA) (4.67±1.66mm2 vs. 5.57±1.57mm2; p=0.04) as well as Minimum Lumen Area (MinLA) (5.98±1.98mm2 vs. 6.73±1.87mm2; p=0.04). Moreover, eccentricity index showed a significant reduction between 3 and 5years (0.28±0.35mm2 vs. 0.16±0.06mm2; p=0.04). We identified a total of 3 SBs ostia in the segments treated with BVS. Between 3 and 5years follow-up in all SB analysed, we detected a decrease of mean tissue bridge thickness and an increase of calculated SBs area. CONCLUSIONS: In our serial OCT, a significant decrease of tissue bridge formation together with SB orifice area enlargement from 3 to 5year follow-up has been proved.