scholarly journals The FAME Trials: Impact on Clinical Decision Making

2016 ◽  
Vol 11 (2) ◽  
pp. 116 ◽  
Author(s):  
Guy R Heyndrickx ◽  
Gábor G Tóth ◽  
◽  
Keyword(s):  
Medical Treatment ◽  
Fractional Flow Reserve ◽  
Clinical Decision Making ◽  
Stable Coronary Artery Disease ◽  
Coronary Intervention ◽  
Clinical Decision ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Stenosis Severity ◽  
Artery Disease

Careful and stepwise evaluation of the fractional flow reserve (FFR) index has been performed over the years, culminating in the landmark Fractional Flow Reserve Versus Angiography for Multivessel Evaluation (FAME) and Fractional Flow Reserve-Guided Percutaneous Coronary Intervention Plus Optimal Medical Treatment Versus Optimal Medical Treatment Alone in Patients with Stable Coronary Artery Disease (FAME II) trials. Findings from these studies demonstrated unequivocally the overall inadequacy of angiography versus FFR to correctly assess stenosis severity. Thus, proof of concept and clinical applicability was established beyond debate and will be discussed here.

scholarly journals Current Use of Fractional Flow Reserve: A Nationwide Survey

2014 ◽  
Vol 41 (6) ◽  
pp. 579-584 ◽  
Author(s):  
Bashar Hannawi ◽  
Wilson W. Lam ◽  
Suwei Wang ◽  
George A. Younis
Keyword(s):  
Fractional Flow Reserve ◽  
Stable Coronary Artery Disease ◽  
Nationwide Survey ◽  
Coronary Intervention ◽  
Survey Study ◽  
Medical Society ◽  
Fractional Flow ◽  
Case Volume ◽  
Flow Reserve ◽  
Artery Disease

Major medical society guidelines recommend the measurement of fractional flow reserve (FFR) as an aid in choosing percutaneous coronary intervention in patients with stable coronary artery disease. We investigated the measurement of FFR among interventionalists, analyzing operators' attributes and decision-making processes to reveal differences in their applications of FFR and the reasons for those differences. An electronic survey study of 1,089 interventionalists was performed from 2 February through 6 March 2012, yielding 255 responses. Most respondents were >45 years old (58%), worked primarily in a community hospital (59%), and performed 10 to 30 cases per month (52%). More than half (145/253, 57%) used FFR measurement in less than one third of cases, and 39 of 253 (15%) never used it. There were no differences in use of FFR by age, practice location, or angiogram volume (P >0.05 for all). Respondents used FFR measurement more frequently than intravascular ultrasonography (73% vs 60%) to help guide the decision to stent (P <0.01). Operators reported that their primary reasons for not using FFR were lack of availability (47%) and problems with reimbursement (39%). There was no difference in FFR use by operator age, practice setting, or case volume.

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