The role of pullback pressure gradient in guiding coronary artery disease management
- 24 May 2026
- journal article
- Published by Taylor & Francis in Future Cardiology
- Vol. 22 (6) , 601-605
Abstract
Coronary artery disease (CAD) remains the leading cause of death worldwide. Integrating coronary physiology into treatment decision-making is essential to optimize outcomes. Fractional flow reserve (FFR) is the gold standard for assessing the severity of CAD (ischemia) and guiding percutaneous coronary intervention (PCI). However, a single value of FFR cannot capture the spatial distribution of CAD along the vessel. The pullback pressure gradient (PPG) obtained from manual FFR pullbacks is a novel metric for characterizing pressure loss patterns on a continuous scale: values approaching 1.0 represent a focal CAD pattern, whereas values close to 0 represent diffuse disease. PPG predicts flow improvement and angina relief after PCI. This review summarizes the current evidence on PPG and discusses the integration of this novel approach in CAD management.Keywords
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