Understanding the value of physiology
- Featuring |
- May 26 2026
- Duration 1: 59: 59
Drs. Allen Jeremias and Hayder Hashim emphasize that coronary physiology—not angiography alone—should guide what to treat and how to plan PCI. They advocate starting with physiology to identify ischemia and combine this insight with intravascular imaging to identify plaque modification and precisely plan stent length and placement. Drawing on data from studies such as DEFINE PCI and DEFINE GPS, they highlight that residual ischemia after PCI is common and often explains persistent angina, underscoring the value of both pre- and post-PCI physiological assessment.
At-a-glance:
- [0:12] Emphasis on starting with coronary physiology to help guide PCI procedure
- [2:53] Discussion of the importance of combining physiology with imaging for precise procedure planning
- [6:23] Data highlighting why 1 in 4 patients are leaving the cath lab with residual ischemia
- [?] Summary of the value of both pre and post physiological assessment
In this expert discussion, Drs. Allen Jeremias and Hayder Hashim explore why coronary physiology should be the foundation of PCI decision-making. Rather than relying on subjective angiographic interpretation, they highlight the value of physiological assessment to identify ischemia, understand disease patterns, and plan treatment with confidence.
By combining physiology with intravascular imaging, physicians can precisely determine what to treat, how much to treat, and where to land—reducing guesswork and unnecessary stenting. Advanced tools such as SyncVision help quantify lesion contribution and predict post-PCI outcomes, supporting more informed procedural planning.
Supported by evidence from DEFINE clinical trials, this integrated approach demonstrates how physiology-guided, imaging-supported PCI can help minimize residual ischemia, reduce persistent angina, and improve patient outcomes—pointing toward the future standard of care in the cath lab.
Once I determine what to fix (with physiology), I re-engage again with imaging to understand if I need to modify the plaque, because I do believe combining the two modalities is the future.
Dr. Hashim Hayder
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Disclaimer
Results are specific to the institution where they were obtained and may not reflect the results achievable at other institutions. Results in other cases may vary.