TCT 2018 | FAST-FFR: Angiography-Derived FFR Without Hyperemic Stimulus or Invasive Guidewire Placement

All over the world, functional lesion measurement remains underutilized due to the need for a hyperemic stimulus (which may be avoided with instantaneous wave-free ratio [iFR]) and, above all, the invasiveness of guidewire placement (crossing the intended lesion) for the measurement. These guidewires have improved a lot, but they still lack the navigating capacity of the workhorse guidewires we often choose.

TCT 2018 | FAST-FFR: FFR derivado de la angiografía, sin hiperemia y sin necesidad de cruzar la lesiónThis spurred the emergence of fractional flow reserve (FFR) derived from coronary angiography, and this work (presented at TCT 2018 and published simultaneously in Circulation) tries to determine the specific diagnostic capacity of this new method.

 

Coronary angiography was performed in lesions of varying severity, and then FFR was measured using a coronary pressure wire and hyperemic stimulus. At least two different projections were carried out, and on-site operators were blinded to FFR and calculated the angiography-derived FFR using proprietary software.


Read also: TCT 2018 | TriValve: Mitraclip for the Tricuspid Valve.


The primary endpoints were the sensitivity and specificity of the new method vs. standard invasive FFR using a cutoff value of 0.80.

 

A total of 301 patients and 319 vessels were assessed in 10 centers in the United States, Europe, and Israel. The mean FFR was 0.81 and 43% of vessels had values ≤0.8.


Read also: TCT 2018 | SOLVE-TAVI: Self-Expandable vs. Balloon-Expandable Valves and General vs. Local Anesthesia in One Study.


New method sensitivity and specificity were 94% (95% confidence interval [CI]: 88% to 97%) and 91% (95% CI: 86% to 95%), respectively. Both exceeded pre-specified performance goals.

 

Original title: Accuracy of Fractional Flow Reserve Derived from Coronary Angiography.

Presenter: William F. Fearon.

 

FAST-FFR-presentación

FAST-FFR-artículo-original


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

More articles by this author

ACC 2025 | FAME 3: FFR Guided PCI vs CABG 5 Year Outcomes.

Earlier studies comparing percutaneous coronary intervention (PCI) vs coronary artery bypass graft (CABG) have shown fewer events at long term for the surgical strategy.  However,...

CRABBIS Trial: Comparison of Different Provisional Stenting Sequences

Provisional stenting (PS) is the gold standard for percutaneous coronary intervention (PCI) in most patients with coronary bifurcation lesions (CBL). Moreover, recent studies such...

Andromeda Trial: Meta-Analysis of Drug Coated Balloon vs. DES in Small Vessel DeNovo Lesions

The use of coronary stents vs plain old balloon angioplasty (POBA), has allowed to reduce recoil and limiting flow dissection which were major limitation...

QFR vs. FFR: Is Coronary Revascularization Deferral Safe? Results from a FAVOR III Sub-Analysis

In cases of intermediate coronary lesions, functional assessment is recommended to aid the decision-making process regarding revascularization. There are several tools currently used to...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

ACC 2025 | FAME 3: FFR Guided PCI vs CABG 5 Year Outcomes.

Earlier studies comparing percutaneous coronary intervention (PCI) vs coronary artery bypass graft (CABG) have shown fewer events at long term for the surgical strategy.  However,...

ACC 2025 | API-CAT: Reduced vs. Full Dose Extended Anticoagulation in Patients with Cancer Related VTE

The risk of cancer related recurrent venous thromboembolism (VTE) will drop over time, while bleeding risk will persist. At present, it is recommended we...

STRIDE: Semaglutide in Patients with Peripheral Arterial Disease and Type II Diabetes

Peripheral arterial disease (PAD) is a severe complication in patients with type II diabetes, primarily affecting peripheral vessels, especially below-the-knee (BTK) arteries. This condition...