관상동맥 질환에서 압력철선의 유용성
Role of Pressure Wire in Coronary Artery Disease
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초록
관상동맥 조영술이 관상동맥 질환의 진단과 치료에 사용된 오랜 세월 동안 좀더 정밀하게 질환을 파악하기 위해 여러 새로운 장비와 기술들이 개발되어 왔으며, 그중 압력철선을 이용한 FFR은 다양한 병변에서 심근허혈의 유발 여부를 판단하여 재관류 시술의 필요성, 위치와 방법 등을 결정할 때 도움을 주고 있다. 뿐만 아니라 시술 후 평가, 시술에 따른 장기예후 추정, 미세혈관 기능 평가 및 비관상동맥 질환분야까지 그 활용도를 넓히고 있다. 이러한 다양한 상황에서 압력철선을 사용하기 위해서는 압력철선 사용의 제한점을 잘 이해하고 정확히 적용함으로 그 신뢰도를 높일 수 있겠다. 관상동맥 질환의 중재적 치료가 지속적으로 증가하고 있는 시대적 흐름으로 보아 압력철선의 사용은 환자와 시술자 모두를 위해 긍정적인 방향으로 증가할 것으로 기대된다.
Abstract
To get the best clinical outcome after revascularization, understanding of patient and lesion should proceed. Although coronary angiography has been regarded as the gold standard for assessing coronary artery disease for several decades, it has several well-known limitations. Fractional flow reserve (FFR), measured with a coronary pressure wire, is an accurate and lesion-specific index for determining the functional significance (myocardial ischemia) of a particular stenosis. The selection of target vessels, the decision and method for revascularization, and the determination of prognosis in patients with CAD can be helped by FFR in daily practice. In this manuscript, we will review the role of pressure wire and discuss the limitation of it in evaluating CAD. (Korean J Med 2011;81:708-715)
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