ISSN 2771-6309

International Journal of Clinical Images and Medical Reviews

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International Journal of Clinical Images and Medical Reviews


International Journal of Clinical Images and Medical Reviews (ISSN 2771-6309) is a peer reviewed journal dedicated to publishing clinical images, Case Reports, Researches, Reviews, Mini Reviews, Short communications etc, from all sectors of science and medicine. The goal of this magazine is to disseminate information about new discoveries and treatments in science and medicine and accepts topics such as surgery, histology and cytology, oncology, dentistry, immunology, diagnostic method, clinical case, transplantation, ophthalmology, forensic science and all medicine-related fields.

International Journal of Clinical Images and Medical Reviews is open access journal, a peer reviewed journal with a large intellectual impact. Before publishing a manuscript, it goes through a rigorous editorial review procedure. The authors are encouraged to provide the manuscripts in accordance with the guidelines. The work can be submitted online using an online submission system. The manuscripts are peer-reviewed before being verified by the editors' panels. Finally, in order to preserve the highest quality of the information in this journal, only the quality contents are published.

Aims and Scope




Eosinophilia After Exposure to Darbepoetin alfa: A Case Report

Darbepoetin alfa stimulates erythropoiesis in manner similar to re- combinant human erythropoietin (rEPO). It differs from rEPO as there are two additional oligosaccharide chains in darbepoetin alfa.1 These two chains increase the number of sialic acid residues within the molecule, thereby enhancing its half-life three-fold compared to rEPO.1 U.S. Food and Drug Administration label for Darbepoetin alfa indicates that allergic rash and erythema can occurred in 5% of patients taking darbepoetin alfa,2 which may be due to the immuno- genic nature of darbepoetin alfa owing to different amino acid and oligosaccharide chain sequences (compared to endogenous EPO and rEPO).
DOI: 10.55920/IJCIMR.2022.03.001103

A New Strategy to Build Culture of Compassion in Nursing Practice

Values are generally defined as beliefs or principles that influence behaviour. Following several reports that revealed poor care quality with an apparent lack of compassion, England's Department of Health (DH) introduced the ‘6Cs’ as values for practice within a new nursing strategy. In 2016, the 6Cs were included in the new framework for nursing (1). This article sets out the background to the 6Cs, considers other sets of values relevant to nursing practice and theories of caring, and then explores the meaning of the DH’s 6Cs in detail.
DOI: 10.55920/IJCIMR.2022.03.001102

CIUs as a Measure of Communicative Performance in a Persian Speaker with Anomic Aphasia

Aphasia is an acquired neurological language disorder, primarily due to brain injury caused by stroke, which affects language comprehen- sion and production. Anomia is a type of aphasia, which according to American Hearing and Speech Association (ASHA) is defined as a mild form of aphasia with word-finding difficulty being the main characteristic. Individuals with anomic aphasia have relatively pre- served speech fluency, repetition, comprehension, and grammatical speech but sometimes have difficulty with word retrieval (Dronkers & Baldo, 2010)
DOI: 10.55920/IJCIMR.2022.03.001101

Incidental Finding of Lumbar Rib

An incidental finding of “thirteenth” or “lumbar” rib was discovered upon radiological imaging. An oblique radiograph shows the costo- vertebral articulation (Figure 1., white arrow) between the first lumbar vertebra and the rib. Axial CT also demonstrates the articulation as well (Figure 2., white arrow). Three-dimensional volume rendered CT provides a clear view of the bony architecture of the spine (Figures 3 and 4).
DOI: 10.55920/IJCIMR.2022.02.001100

Pyrimidine Metabolism-related gene RRM2 as a novel biomarker for Prognosis and immu- notherapy in LUAD

Lung adenocarcinoma (LUAD), which accounts for 40% of lung can- cers, is usually diagnosed at an advanced stage and has a low aver- age 5-year survival rate (about 20%) [1] [2] [3]. To promote tumor growth, tumor cells initiate a unique metabolic program [4] [5]. This is not only conducive to the unlimited proliferation of tumor cells, but also shapes a unique immune microenvironment, affecting the com- position and biological functions of immune cells in the microenvi- ronment [6] [7].
DOI: 10.55920/IJCIMR.2022.02.001097

Total Knee Arthroplasty: Socioeconomic Disparities of Post-Operative Complications

A 2018 American Academy of Orthopedic Surgeons report predicts that TKA rates will increase by 189% in 2030 and by 382% in 2060.2 Current projections are that by 2030, there will be 935,000 primary TKAs annually.1 Healthcare disparities continue to be a concern for total knee arthroplasties (TKAs), and given the anticipated increase of TKAs, these disparities need to be addressed. Elderly patients un- dergoing TKA, such as the Medicare beneficiaries analyzed in this study, have an increased perioperative risk and require close interdis- ciplinary cooperation for success. For these patients, post-operative function depends significantly upon psychosocial factors in addition to a patient’s preoperative health status.
DOI: 10.55920/IJCIMR.2022.02.001096


In individuals with low back pain, sacroiliac joint (SIJ) is the most common pain causing joint (1). SIJ is developed by the junction be- tween iliac bone and sacral bone. Association between two bones, muscles and ligaments provide the stability to the joint. This joint is the largest joint of body with a diameter of 17.5 cm2 (2). Low back pain approximately affects 80% of the population. It is extremely com- mon and thus continues to affect millions of people every year. It is a difficult condition to treat effectively and so it causes a huge financial burden on the patients as well as the hospitals.
DOI: 10.55920/IJCIMR.2022.02.001095

Evaluation of the Relationship between the Adherence to the Treatments of Individuals with Chronic Obstructive Pulmonary Disease and their Attitudes Towards Complementary and Alternative Medicine in the COVID-19 Pandemic

Chronic Obstructive Pulmonary Disease (COPD) is one of the im- portant causes of morbidity and mortality among chronic diseases. Periods of exacerbation seen during the disease process can cause progression of the disease, increase in health expenditures and mor- tality (1). The leading cause of COPD exacerbations is the occurrence of tracheobronchial infections. Viral agents are shown as the source of tracheobronchial infections (2). All these data; It predicts that in- dividuals with COPD may be adversely affected by the new type of coronavirus (COVID-19).
DOI: 10.55920/IJCIMR.2022.02.001094

Monogenic systemic lupus erythematosus associated with DNASE1 gene mutation: a case report and literature review

Systemic lupus erythematosus (SLE) in children is an autoimmune disease that can involve multiple systems, and its pathogenesis is genetically related, with single mutations causing the disease being extremely rare [1]. No cases of SLE associated with mutations in the deoxyribonuclease 1 (DNASE1) gene have been reported in China, and only four cases have been reported abroad [2-3]. One case of monogenic SLE in a young child associated with DNASE1 mutation was diagnosed in our hospital through clinical features, autoantibody examination and genetic testing, and the diagnosis and treatment of this case are reported below.
DOI: 10.55920/IJCIMR.2022.02.001093

A New Strategy to Build Culture of Compassion in Nursing Practice

Values are generally defined as beliefs or principles that influence behaviour. Following several reports that revealed poor care quality with an apparent lack of compassion, England's Department of Health (DH) introduced the ‘6Cs’ as values for practice within a new nursing strategy. In 2016, the 6Cs were included in the new framework for nursing (1).
DOI: 10.55920/IJCIMR.2022.02.001092

Two case reports of successful Endovascular treatment of Vertebrobasilar insufficiency: A Case of an incomplete Balint syndrome and recurrent Vertebrobasilar stroke

High-grade vertebrobasilar insufficiency is an important cause of posterior circulation stroke. It is characterized by symptoms such as ataxia, diplopia, hemianopia, cranial nerve palsies and decreased level of consciousness. Among rare clinical presentations, Balint syndrome consists of the triad of simultanagnosia, oculomotor apraxia and optic ataxia. It is frequently associated with bilateral ischemic parieto-occip- ital lesions or some neurodegenerative diseases.
DOI: 10.55920/IJCIMR.2022.02.001091

A Rare form of Urinary tract Infection in a Transplanted patient

A 62-years-old woman with end-stage renal disease received a 2nd kid- ney transplant. The early post-transplant period was complicated with lymphocele formation, causing bladder and ureteric compression, and left iliac vein thrombosis. The lymphocele was initially treated with local drainage and warfarin was also initiated for vein thrombosis. After two months the patient presented with worsening kidney func- tion and reformation of lymphocele.
DOI: 10.55920/IJCIMR.2022.02.001090

Eosinophilic Myocarditis presenting with progressive Cardiac Cachexia

Hypereosinophilic syndrome (HES) is a rare hematologic disorder characterized by persistent overproduction of eosinophils causing multiple organ damage (1). Cardiac involvement in HES is frequent, found in approximately 50% of patients with HES, and is associated with high morbidity and mortality rates (2-4). It is caused by eosino- phil infiltration of the endomyocardium with subsequent tissue dam- age and endomyocardial fibrosis (5).
DOI: 10.55920/IJCIMR.2022.02.001089


Oral melanocytic nevi (OMNs) are rare and benign melanocytic tu- mors [2, 5, 7, 11]. Long associated with hamartomas, melanocytic nevi are now considered as neoplasms [7]. OMNs can be congenital or acquired. They are classified histologically as junctional, compound, intradermal, combined and blue. This classification is correlated with the location, morphology of the cells and their distribution [2,7].
DOI: 10.55920/IJCIMR.2022.02.001088

Digital phantoms for evaluating the dosimetric Impact of MRI Geometric inaccuracy in SBRT planning for liver cancer in the presence of motion

Recent advances in radiation therapy have placed Stereotactic body radiation therapy (SBRT) as a superior therapeutic option for the treatment of various tumors especially in the liver compared to other RT techniques [1 - 5]. SBRT has shown a sustain improvement of local control rates of tumors that are subject to motion.
DOI: 10.55920/IJCIMR.2022.02.001087

An Unusual cause of Pelvic Pain: Giant Rectosigmoid Lithobezoar in a big Child

We report the case of a rectosigmoid lithobezoar. He was a 10 years old boy, without any particular history, who was seen in consultation for pelvic pain and difficulty to defecate. The examination revealed a firm mass in the left iliac fossa and hypogastrium. On rectal examina- tion, a firm, friable formation with telluric debris on the glove was found.
DOI: 10.55920/IJCIMR.2022.02.001086

Perspectives of Jaundice and Implications

Jaundice involves yellowing of the skin, whites of the eyes, and body fluids. It is as a result of high level of bilirubin in the blood [1]. The bilirubin simply is a yellow pigment that is generated from haem me- tabolism, mainly from haemoglobin in red blood cells (RBCs). This bilirubin is moved by the blood to the liver, where it is linked with a sugar by an enzyme through conjugation so that it can be excreted in bile, which later reach the small intestine. It has been reported that jaundice may result from a problem at any point in the pathway es- pecially increased breakdown of RBC, liver dysfunction or problems with excretion of bile [2].
DOI: 10.55920/IJCIMR.2022.02.001085

Diffuse biliary papillomatosis (IPNB) associated with IPNM : a case report

Biliary papillomatosis is a rare event. It concerns the biliary epithelium. The definition of the World Health Organization is the presence of multifocal papillary lesions on intra hepatic and/or extrahepatic bile ducts 1. There is a risk of malignant transformation. The papillary lesions are producing mucus conducting to biliary obstruction. Right hypochondrium pain and jaundice are the more frequent symptoms.
DOI: 10.55920/IJCIMR.2022.02.001083

Evaluation of predictive factors associated with prognosis of patients with Solitary Hepatocellular Carcinoma receiving transcatheter Arterial Chemoembolization

Hepatocellular carcinoma (HCC) occurs most often in underlying chronic liver diseases including advanced fibrosis or cirrhosis, which is usually related to chronic hepatitis B virus (HBV), hepatitis C virus (HCV) infection, prolonged alcohol use, or nonalcoholic fatty liver disease.1.2 The Barcelona Clinic Liver Cancer (BCLC) staging system can be used to assess therapeutic options,3 such as transcatheter arterial chemoembolization (TACE), which is recommended as the treatment modality for intermediate stage, or BCLC stage B, HCC.
DOI: 10.55920/IJCIMR.2022.02.001082

Negative Pressure Wound Therapy for Necrotizing Fasciitis of the Head and Neck: A Case Report

Necrotizing fasciitis (NF) is an acute severe infection of the superficial fascia that rapidly progresses, causing fascial necrosis with serious damage to the surrounding skin, subcutaneous tissue, muscle, and soft tissue. It can be caused by polymicrobial bacteria including mixed aerobic and anaerobic species. The incidence rate of NF is approximately 3.5–4 cases per 100,000 people. Among them, cervical NF accounts for only approximately 5%.
DOI: 10.55920/IJCIMR.2022.02.001081


Cholangiocarcinoma is an aggressive malignancy and a challenging disease to treat, with available literature emphasizing on surgical resection, newer imaging modalities, adjuvant therapy, and palliative therapy, but just establishing a tissue diagnosis itself is the most complex problem before treating such tumors especially in proximally located hilar biliary stricture.
DOI: 10.55920/IJCIMR.2022.02.001080


Pancreatic fistula is a rare complication of acute pancreatitis, chronic pancreatitis and pancreatic trauma. It develops because of pancreatic ductal disruption or rupture of a pseudocyst. Pancreatic ascites develops due to free secretion of pancreatic juice into peritoneal cavity . Its challenging to diagnose this rare complication and even more challenging to treat it adequately . Left pleura is the most common location for pancreatic fistula followed by right pleura and both pleural cavities.
DOI: 10.55920/IJCIMR.2022.02.001079

Gut microbiota and Intestinal Immune systems -Immune control functions via short-chain fatty acids, Amino acid metabolites and Bile acids

Intestinal environments, including gut microbiota, are deeply involved in the developments and control of intestinal immune systems. Gut microbiota exerts various actions on immune cells through bacterial cell components and metabolites produced by the bacteria.
DOI: 10.55920/IJCIMR.2022.02.001078

Acute Kidney injury and COVID-19 infection

Coronavirus disease (COVID-19) is an infection that has been one of the most frequently discussed medical as a socio-economic issues over the past two years. Common risk factors for COVID-19 infection and its severe course include age, race, male gender, chronic lung disease, cardiovascular disease (CVD), diabetes mellitus (DM), immunode- ficiency, kidney and liver disease, obesity/overweight, smoking and polypharmacy.
DOI: 10.55920/IJCIMR.2022.02.001077

To determine sensitivity of diffusion weighted imaging for diagnosis of hepatocellular car- cinoma, keeping the dynamic post contrast MRI as gold standard.

There is increasing incidence of hepatocellular carcinoma (HCC) worldwide, being the fifth commonest cancer and holds being the sec- ond commonest reason of cancer death [1]. It is alarmingly on rise in Pakistan [2, 3]. Multiple risk factors for HCC have been documented worldwide, a few include alcohol, hepatitis B and C viral infection and non-alcoholic fatty liver disease (NAFLD). With current disease load it is crucial to accurately diagnose HCC at the early stage for reduc- ing the morbidity and mortality. Early diagnosis is the rate limiting step in the disease burden.
DOI: 10.55920/IJCIMR.2022.02.001076

The using of biphasic calcium sulfate in two-stage treatment of odontogenic fibroma of the mandible – case report

Among the patients of the Oral Surgery Department, a significant per- centage are people requiring treatment due to the diagnosis of odon- togenic cysts in the jaw bones. Most of these cysts, of various etiolo- gies, require surgical treatment. The most common lesions of various origins include the germinal cyst, while the broadly understood root cyst, as a chronic inflammatory pathological condition, may constitute the highest percentage of recognizable lesions of this type in the jaw bones. Statistically, it is over 60% of odontogenic cysts and over 50% of bone cysts[1,2].
DOI: 10.55920/IJCIMR.2022.02.001075

Dietary Mineral Imbalance among Primary School Children in Benghazi

Childhood is the entire blueprint of an individual's future life, evi- dences show that experiences in early and middle childhood are extremely important for a child’s healthy development and lifelong learning. How a child develops during this time affects future cog- nitive, social, emotional, language, and physical development, which in turn influences school readiness and later success in life 1-3
DOI: 10.55920/IJCIMR.2022.02.001074

Chronic GI Bleeding as the Only Presenting Sign of AML in an Elderly Patient

While acute myeloid leukemia (AML) remains a common type of leukemia in adults, it is a relatively rare cancer diagnosis overall, re- sponsible for only one percent of adult cancer deaths in the United States.1-3 AML stems from the malignant clonal expansion of undif- ferentiated myeloid precursor cells, resulting in ineffective hematopoi- esis and bone marrow failure.1,2 The production of malfunctioning white blood cells can cause cytopenia’s, creating downstream symp- toms related to anemia and thrombocytopenia.1-4 However, a handful of individuals may be asymptomatic upon diagnosis with isolated lab abnormalities.
DOI: 10.55920/IJCIMR.2022.02.001073


Immune thrombocytopenia (ITP) is an autoimmune bleeding disor- der that lessens the production of platelets. ITP is a syndrome char- acterized by: (i) thrombocytopenia (platelet count less than 100,000/ mm3); (ii) shortened platelet survival; (iii) presence of antiplatelet an- tibody in the plasma; (iv) normal or increased megakaryocytes in the bone marrow [1]. Patients are over 60 years of age with no predilection for sex and the chronic form being the most common.
DOI: 10.55920/IJCIMR.2022.02.001072

Postpartum Depression: A Comprehensive Review

Postpartum depression is a form of depression, a mental illness, dis- covered to be common lately in birth mothers affecting roughly 15% to a minimum of 10%. Such a period is very critical due to its nature and effect on Mother-baby bonding and Child’s long-term Devel- opment. However, following depressions are found to be very inad- equately diagnosed and nursed. According to the survey carried out in this regard revealed that halves of such conditions are unidentified by concerned Practitioners or medical Professionals in-charge and revealed that most of the diagnosed mothers, do not follow recom- mended treatment accordingly.
DOI: 10.55920/IJCIMR.2022.02.001071

Prevalence of cervical epithelial cell dysfunction in Papanicolaou smears reports in low-risk population referred to Imam Reza hospital

Cervical cancer is one of the most preventable malignancies among human cancers. Infection of the uterine cervix with human papilloma- virus (HPV) is the main causative agent of cervical cancer [1]. About 15 high-risk types of human papilloma virus have been identified, which are responsible for cervical neoplasia and other related cancers [2]. Cervical cancer with worldwide distribution, though a prevent- able disease, is one of the leading causes of cancer death in women.
DOI: 10.55920/IJCIMR.2022.02.001070

The Effect of Gestational Diabetes on the α7 and α4 Subtypes of nAChRs in Human Placenta

Gestational diabetes mellitus (GDM) is developed among those preg- nant women with inadequate pancreas function that cannot overcome resistance to insulin [1]. GDM increases blood glucose level that can be initiated or diagnosed for the first time in pregnancy. It was esti- mated that diabetes affects up to 15 % of pregnant women worldwide [2]. Moreover, its prevalence is increasing in all parts of the world [3].
DOI: 10.55920/IJCIMR.2022.02.001069

Myocardial infarction following COVID-19 vaccination

The rapidly spreading COVID-19 virus has killed millions(1). Vac- cination is the best way to prevent severe illness and death(2). Local reactions at the injection site and nonspecific systemic effects (myal- gia, chills, fatigue, headache, and fever) are common side effects of this vaccine(3).
DOI: 10.55920/IJCIMR.2022.02.001068


Prinzmetal's Angina is a rare cause of chest pain. It occurs when a cor- onary artery goes into spasm, usually among young patients leading to angina pectoris with electrocardiographic changes. 1The spasm can be focal or diffuse and affect the epicardial or microvascular coronary arteries, in addition there is a risk of sudden death, acute coronary syndrome, syncope and arrhythmias.
DOI: 10.55920/IJCIMR.2022.02.001067

Clinicopathological analysis of 20 cases of subcutaneous sarcoidosis in South Korea

Sarcoidosis is a multisystem granulomatous disorder of unclear ori- gin.1 The diagnosis of sarcoidosisis well established when clinical and radiological findings are supported by histological evidence of non- caseating granulomas in one or more tissues.2 It involves mainly the lungs, mediastinal and peripheral lymph nodes, skin, liver, spleen, eyes and parotid glands.
DOI: 10.55920/IJCIMR.2022.02.001066

Effects Of Ethnicity On Allogenic Stem Cell Mobilization

Allogeneic stem cell transplant (ASCT) is a treatment method for var- ious malignant and non-malignant hematologic disorders. The plu- ripotent hematopoietic stem cells are usually obtained from the bone marrow or peripheral blood of a donor. The results of allogeneic bone marrow transplantation from the human leukocyte antigen (HLA) compatible sibling are much better.
DOI: 10.55920/IJCIMR.2022.02.001065


Mastocytosis is characterized by an abnormal mast cell infiltrates. It can occur at any age. Severity of this disease ranges from fleetingly benign to aggressively malignant contitions. Cutaneous mastocytosis is most common in children. About 50% of affected children develop typical skin lesions before the age of 6 months.
DOI: 10.55920/IJCIMR.2022.02.001064

Sickle cell disease and projection into future in African patients living in France, born in Africa and those born in France from African Parents

Sickle cell disease (SCD) is a serious chronic disease that manifests itself from early childhood with intense pain, chronic anemia, infec- tions to which can be added acute and chronic complications affecting the brain, heart, lungs, and kidneys, among others. All organs can be affected. A genetic disease, it is transmitted to the child by both par- ents, each carrying the S gene for sickle cell disease.
DOI: 10.55920/IJCIMR.2022.02.001063

A Technique for Prosthetically Aligning Multiple Non-Parallel Implants

Placing implants in a proper prosthetic position and direction is es- sential to achieve a successful long-lasting restoration.1 However, this is sometimes difficult to achieve because of anatomical or technical difficulties and angled abutments are required to correct the unfavor- able alignment.
DOI: 10.55920/IJCIMR.2022.02.001062

Importance of Maintaining and Improving Immune Function by Physical Activity During the COVID-19 Pandemic

In early December 2019, a novel coronavirus disease, designated as COVID-19, came into light in Wuhan, Hubei Province of China. With the first pneumonia cases of unknown origin being identified, it has be- come a pandemic worldwide. The World Health Organization (WHO) has declared it as a potential threat to the world population, and a pub- lic health emergency of international concern on January 30, 2020.
DOI: 10.55920/IJCIMR.2022.02.001061

Combined cervical laceration and bladder rupture: a case report of an unusual complica- tion of precipitated labor

Spontaneous bladder rupture following normal vaginal delivery is a surgical postpartum emergency. Previous cesarean section, vacuum/ forceps-assisted vaginal deliveries, and distended bladder compressed by engaged head in birth canal are all risk factors for bladder injuries in healthy parturient women 1.
DOI: 10.55920/IJCIMR.2022.02.001060

Research Progress of Rhubarb in the Treatment of Liver Fibrosis

Liver fibrosis is the excessive accumulation of extracellular matrix proteins including collagen that occurs in most types of chronic liver diseases.It is a complex disease centered on the activation of hepatic stellate cells and regulated by a variety of cell signal transduction pathways.Advanced liver fibrosis can results in cir - rhosis, liver failure, and portal hypertension.
DOI: 10.55920/IJCIMR.2022.02.001056

Unilateral Biportal Endoscopy Discectomy for High Grade Migrated Lumbar Disk Herniation with a Homemade Guider

Compared with open lumbar disk herniation discectomy, percutane- ous endoscopic discectomy(PED)has advantages of smaller incision and faster recovery in the treatment of lumbar disk herniation. Al- though successful results have been achieved with the improvement of technology and equipment, the application of PED to treat high- migrated disc herniation is still technical challenging.
DOI: 10.55920/IJCIMR.2022.02.001055

Development of a novel dental thermal imaging application

Thermography is a process where a (thermal) camera captures and generates an image by using infrared radiation, emitted from an ob- ject [1]. The image provides an opportunity to visibly record invisible (to the human eye) infrared energy or heat. Thermography is non- invasive, non-contact, user-friendly and a portable imaging method and has been used in various industrial fields, such as engineering and construction.
DOI: 10.55920/IJCIMR.2022.02.001054

Retained Severed Radial Arterial Catheter

The radial artery is the most frequently utilized site for arterial can- nulation due to accessibility and safety, with approximately 8 million catheters placed per year in the USA.1 Radial artery cannulation is associated with a major complication rate of less than 1%. While the most common complication is temporary occlusion (19%), common complications such as thrombosis.
DOI: 10.55920/IJCIMR.2022.02.001053

Validation of regional wall motion abnormality assessment methods based on coronary CT- angiography with left ventricular function regarding prediction of hemodynamically rel- evant stenoses with instantaneous wave-free ratio

Invasive coronary angiography (ICA) is the gold standard for diag- nostic and treatment of CAD in high-risk patients [1]. Patients with stable angina or silent ischaemia undergo revascularization therapy when ischaemia or a hemodynamically relevant stenosis are detected [2]. The DEFINE-FLAIR and iFR-SWEDEHEART randomized tri- als demonstrated similar outcomes in FFR (fractional flow reserve) and iwFR (instantaneous wave-free ratio) guided revascularizations in patients with intermediate-grade stenosis [3, 4].
DOI: 10.55920/IJCIMR.2022.02.001051

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