Sistemas de diagnóstico intracoronario: cuándo utilizarlos y qué técnica elegir
La técnica habitual para el diagnóstico de la enfermedad coronaria es la angiografía con contraste, y es ésta sobre la que está basada la mayor parte de la evidencia científica sobre el diagnóstico, pronóstico y manejo de esta patología. No obstante, frecuentemente, la evaluación sólo mediante coronariografía no es suficiente para una correcta valoración de una determinada estenosis coronaria ni del resultado de una intervención coronaria percutánea. En estos casos, la utilización de técnicas adicionales de diagnóstico intracoronario (es decir, que utilizan sistemas que se introducen dentro de la luz de los vasos coronarios), puede ser de gran ayuda. Básicamente, las técnicas de diagnóstico intracoronario pueden ser morfológicas (que aportan imágenes de alta resolución) o funcionales.
Se analizarán las siguientes técnicas: la ecografía intracoronaria, la tomografía de coherencia óptica, la guía de presión y la guía de Doppler intracoronario.
Los objetivos de la presente recomendación son:
- Conocer los fundamentos de las diferentes técnicas de diagnóstico intracoronario.
- Conocer cómo se realizan las diferentes técnicas de diagnóstico intra-coronario y qué parámetros se evalúan.
- Conocer las evidencias que existen en la actualidad sobre la utilización de las diferentes técnicas de diagnóstico intracoronario.
- Identificar qué pacientes pueden beneficiarse de la realización de determinadas técnicas de diagnóstico intracoronario.
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