PhD defence T. (Tara) Neleman

Brief summary: 

Over the past decades, numerous innovations in the field of interventional cardiology helped to improve the outcome of patients with coronary artery disease undergoing PCI. Yet, a considerable amount of these patients still experience recurrent angina and target vessel failure (TVF), indicating that there is still room for improvement. Coronary physiology and intravascular imaging have emerged as safe and effective tools to support PCI decision making and to further improve patient outcome. However, despite strong guideline recommendations and due to local restrictions, financial limitations, as well as personal preferences, these valuable techniques remain underutilized. With this thesis, we aimed to integrate the newest developments in the field of coronary physiology and intravascular imaging in daily practice. We discussed the value of vessel fractional flow reserve (vFFR), an angiography-based physiological index, and we proposed a novel intravascular ultrasound (IVUS) analysis algorithm and a machine learning-based calcium quantification tool. Secondly, we sought to evaluate the integrated application and clinical impact of physiology and intravascular imaging to identify subgroups at increased risk and to guide PCI optimization.