iFR Assessment of Intermediate Aortic Stenosis Lesions Consolidates

Once a big void that prevented us from effectively assessing functional compromise, intermediate aortic stenosis has made us treat many lesions “just in case”, to save us what would be a complicated procedure, had a valve been placed. Auspiciously, some light has been shed by several, most welcome, studies simultaneously published in J Am Coll Cardiol Intv.

iFR en lesiones no culpables: el momento de la medición parece cambiar la historiaThis study looked at 95 consecutive patients with severe aortic stenosis and intermediate coronary lesions in 116 vessels. It compared invasive iFR with FFR values and non-invasive adenosine stress myocardial perfusion imaging.  

 

Mean iFR was 0.86 (0.76 to 0.93) and FFR was 0.84 (0.76 to 0.91). According to authors, iFR values showed good correlation with FFR values. However, these figures have different clinical implications, seeing as they have different cutoff values. The authors adjusted iFR cut off value to 0.82, but considered standard an FFR cutoff value of ≤0.75. The latter used to be the original value, the one in the DEFER study, one that has been replaced by 0.8 since the FAME trials.


Read also: Safety of Lesion Deferral with iFR or FFR in Both Stable and Acute Patients.


FFR and iFR values also correlated well with perfusion values.

 

Conclusion

According to this study, iFR, FFR, and stress adenosine prefusion values correlate well in patients with severe aortic stenosis. However, this could be misleading: there was no assessment after procedure to check whether values had changed. In this context, rather than changing cutoff index values, it would be easier to measure with iFR alone, since it is not affected by stenosis, compared to FFR which tends to underestimate severity.

 

Original title: Instantaneous Wave-Free Ratio for the Assessment of Intermediate Coronary Artery Stenosis in Patients with Severe Aortic Valve Stenosis. Comparison With Myocardial Perfusion Scintigraphy.

Reference: Futoshi Yamanaka et al.


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...