What is the take away message from the FAME study for interventional cardiologists?
A third point is that, if you have a very smooth stenosis, which is the same severity as an irregular stenosis, with an irregular surface, then the obstruction to blood flow by turbulence can be quite different. So these are a number of angiographic technical shortcomings. There are many other reasons. If you have a particular stenosis and in an artery that is providing blood flow to a small area of the heart, of course, then it’s less significant than in an artery that provides a large area. There is a kind a relation between a coronary artery and the myocardial territory to be supplied. And this information, this coupling, I would say, is not given by the angiogram, but it is given by the blood flow and by the pressure gradient. Another example is that if you have an artery that is supplying the part of the myocardium which has a previous infarction and which in part has become fibrotic, the same stenosis which could be significant in one case is not significant anymore in the other
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