This study describes the accuracy of the new computed tomography (CT) technique to calculate fractional flow reserve (FFR). Other CT techniques to measure FFR use allometric scaling and assume coronary microvascular resistance. However, instead of assuming these parameters, this new technique calculates them based on coronary and aorta lumen deformation. The accuracy of this...
This randomized trial with an initial plan to include 1832 patients, compared stent implantation guided by fractional flow reserve (FFR) versus optimal medical treatment. In this study, we invasively evaluated the severity of lesion by FFR. Of this population, only patients who had lesions with significant translesional gradient (FFR <0.9) were included in the study...
Original title: Diagnostic Classification of the Instantaneous Wave-Free Ratio Is Equivalent to Fractional Flow Reserve and Is Not Improved With Adenosine Administration. Results of CLARIFY (Classification Accuracy of Pressure-Only Ratios Against Indices Using Flow Study. Reference: Sayan Sen et al. J Am Coll Cardiol 2013;61:1409–20. When considering revascularization, measuring lesion functional compromise is known to improve clinical outcomes...
Assessing intermediate coronary lesions with intracoronary physiology tests such as fractional flow reserve (FFR) or other non-hyperemic indices is considered the standard of care by both American and European societies. Likewise, intravascular imaging techniques (IVI), be it IVUS or optical coherence tomography (OCT), are of great use in assessing and guiding complex coronary lesions and...
Functional assessment of coronary artery lesions with fractional flow reserve (FFR) or instant wave-free ratio (IFR) have shown improvement of most symptoms and clinical outcomes of patients with stable CAD. However, these tools recommended by the current guidelines increase procedure complexity, risk and cost. This is why the angiographic quantitative flow ratio-guided coronary intervention (QFR)...
Current guidelines recommend using fractional flow reserve (FFR) to guide coronary angioplasty. However, intermediate FFR values (0.75-0.80) generate uncertainty about the prognostic value of performing coronary angioplasty over optimal medical treatment. The use of coronary flow reserve (CFR) together with FFR provides further insight into coronary circulation because CFR is an index that also includes...
The FLOWER-MI (presented simultaneously at ACC 2021 and NEJM) hit FFR hard. Its outcomes showed that STEMI patients presenting other non-culprit lesions did not benefit from FFR guided revascularization vs PCI. As it happens with most large studies with unexpected results in the general population, the sub-studies that follow select better samples and, as a...
Functional assessment with fractional flow reserve (FFR) was not better than conventional angiography to guide complete revascularization in patients with multivessel lesions in a setting of ST-segment elevation myocardial infarction and successful primary angioplasty. These results were published in the New England Journal of Medicine (NEJM) and presented during the American College of Cardiology (ACC)...
For many patients, the first symptom of heart disease is acute MI, or even sudden death. Changes in lifestyle and optimal medical treatment (OMT) are vital to the prevention of serious events, but we cannot help wondering whether preventive stenting might do it. Intravascular ultrasound (IVUS), optical coherence tomography (OCT), NIRS near-infrared spectroscopy (NIRS) and computed...
Pressure loss vs. flow curves offer a fundamental synthesis of fluids dynamics in describing aortic valve physiopathology. Severe aortic stenosis is not just an orifice (as suggested by Gorlin) or a segment that offers dynamic resistance. However, once a new transcatheter valve has been implanted, it will behave purely as a resistor. At dobutamine dose,...