scholarly journals Fractional Flow Reserve Assessment of a Significant Coronary Stenosis Masked by a Downstream Serial Lesion

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Lawrence Yu-Min Liu ◽  
Hsu-Ping Wu ◽  
Po-Lin Lin
Keyword(s):  
Fractional Flow Reserve ◽  
Coronary Stenosis ◽  
Bolus Injection ◽  
Coronary Intervention ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Percutaneous Coronary ◽  
Serial Lesion ◽  
Coronary Lesions ◽  
Significant Coronary Stenosis

Fractional flow reserve (FFR) has been recognized as an effective tool to determine functional significance in intermediate coronary lesions and FFR-guided percutaneous coronary intervention (PCI) improves clinical outcomes. However, hemodynamic interaction between serial stenoses within one coronary artery complicates the assessment of functional severity of each individual lesion. We present a case in which FFR measurement by intracoronary bolus injection of adenosine helps to make appropriate revascularization decision in serial stenoses when the procedures are performed systemically and properly.

Fractional flow reserve

2021 ◽  
pp. 63-67
Author(s):  
Giovanni Ciccarelli ◽  
Emanuele Barbato ◽  
Bernard De Bruyne
Keyword(s):  
Blood Flow ◽  
Myocardial Blood Flow ◽  
Fractional Flow Reserve ◽  
Coronary Stenosis ◽  
Coronary Intervention ◽  
Aortic Pressure ◽  
Fractional Flow ◽  
Coronary Pressure ◽  
Flow Reserve ◽  
Percutaneous Coronary

Fractional flow reserve is an index of the physiological significance of a coronary stenosis, defined as the ratio of maximal myocardial blood flow in the presence of the stenosis to the theoretically normal maximal myocardial blood flow (i.e. in the absence of the stenosis). This flow ratio can be calculated from the ratio of distal coronary pressure to central aortic pressure during maximal hyperaemia. More practically, fractional flow reserve indicates to what extent the epicardial segment can be responsible for myocardial ischaemia and, accordingly, fractional flow reserve quantifies the expected perfusion benefit from revascularization by percutaneous coronary intervention. Very limited evidence exists on the role on fractional flow reserve for bypass grafts.

Fractional Flow Reserve: Does a Cut-off Value add Value?

2016 ◽  
Vol 11 (1) ◽  
pp. 17
Author(s):  
Shah R Mohdnazri ◽  
◽  
◽  
◽  
Thomas R Keeble ◽  
...  
Keyword(s):  
Fractional Flow Reserve ◽  
Coronary Intervention ◽  
Grey Zone ◽  
Fractional Flow ◽  
Non Invasive ◽  
Invasive Test ◽  
Flow Reserve ◽  
A Value ◽  
Percutaneous Coronary ◽  
Value Add

Fractional flow reserve (FFR) has been shown to improve outcomes when used to guide percutaneous coronary intervention (PCI). There have been two proposed cut-off points for FFR. The first was derived by comparing FFR against a series of non-invasive tests, with a value of ≤0.75 shown to predict a positive ischaemia test. It was then shown in the DEFER study that a vessel FFR value of ≥0.75 was associated with safe deferral of PCI. During the validation phase, a ‘grey zone’ for FFR values of between 0.76 and 0.80 was demonstrated, where a positive non-invasive test may still occur, but sensitivity and specificity were sub-optimal. Clinical judgement was therefore advised for values in this range. The FAME studies then moved the FFR cut-off point to ≤0.80, with a view to predicting outcomes. The ≤0.80 cut-off point has been adopted into clinical practice guidelines, whereas the lower value of ≤0.75 is no longer widely used. Here, the authors discuss the data underpinning these cut-off values and the practical implications for their use when using FFR guidance in PCI.

scholarly journals Fractional flow reserve versus angiography for guiding percutaneous coronary intervention: a meta-analysis

Heart ◽  
2015 ◽  
Vol 101 (6) ◽  
pp. 455-462 ◽  
Author(s):  
Dongfeng Zhang ◽  
Shuzheng Lv ◽  
Xiantao Song ◽  
Fei Yuan ◽  
Feng Xu ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Fractional Flow Reserve ◽  
Meta Analysis ◽  
Coronary Intervention ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Percutaneous Coronary
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