Assessment of angiographically intermediate coronary artery stenosis using the Doppler Flowire (A Symposium: The Clinical Applications of the Intracoronary Doppler Guidewire Flow Velocity in Patients: Understanding Blood Flow Beyond the Coronary Stenosis)

Determination of the clinical and hemodynamic significance of coronary stenoses is often difficult and inexact. Angiography and coronary vasodilator reserve have been shown to be imperfect tooks to determine the physiologic significance of coronary stenoses. Spectral flow velocity data, both proximal and distal to coronary stenoses, using an 0.018-in intracoronary Doppler-tipped angioplasty guidewire, were compared to translesional pressure gradients and angiography during cardiac catheterization. Patients were divided into 2 groups based on resting translesional gradients: Group 1 had gradients < 20 mm Hg and group 2 had gradients [ is greater than or equal to] 20 mm Hg. Proximal average peak velocity, diastolic velocity integral, and total velocity integral were statistically significantly lower in Group 1. The distal average peak velocity, and diastolic and total velocity integrals were all significantly (p 20 mm Hg (group 2). The ratio of proximal-to-distal total flow velocity integral was also higher in group 2 patients (2.3 [+ or -] 0.9) compared with group 1 (1.1 [+ or -] 0.2; p