fractional flow reserve

La coronariografía precoz reduce la mortalidad en SCA sin supradesnivel del ST de alto riesgo

Compare-Acute Sub-Study: Natural History of Non-Culprit Lesions in MI

The aim of this study was to determine the prognostic value of fractional flow reserve (FFR) of non-culprit lesions in STEMI patients.  We analyzed data of all Compare-Acute patients (Comparison Between FFR Guided Revascularization Versus Conventional Strategy in Acute STEMI Patients With MVD) after PCI, from lesions assessed with FFR and treated medically.  The treating...

Resonancia vs FFR en lesiones no culpables del infarto

MR vs. FFR in Non-Culprit Lesions

Magnetic resonance (MR) and fractional flow reserve (FFR) correlate moderately as regards the assessment of non-culprit lesions in patients admitted with acute myocardial infarction who underwent primary angioplasty. For a similar degree of diagnostic accuracy, we would require a visual, semiquantitative, or fully quantitative comprehensive assessment of lesions. This work, soon to be published in...

La morfología de la placa podría modificar las mediciones funcionales

Plaque Morphology Could Modify Functional Measurements

The vulnerable features of plaque are independently associated to functional measurements done under hyperemia far better than baseline measurements such as iFR. These findings suggest that not only stenosis severity but also plaque features contribute to functional measurements.  This is a sub-study of the PACIFIC (Prospective Comparison of Cardiac PET/CT, SPECT/CT Perfusion Imaging and CT...

Diabetes y enfermedad vascular periférica: viejas drogas con nueva evidencia

Reliability of FFR in Patients with Diabetes: Are Other Parameters Necessary?

Diabetes does not seem to alter the results of a fractional flow reserve (FFR) measurement in a given lesion. Recently, expert opinions and small studies had questioned the reliability of FFR in this specific patient subgroup. This new observational study soon to be published in JAMA vanquishes all doubts and confirms the efficacy of this...

FFR in the Time of ISCHEMIA

The results of this great multicenter “real-life” registry are similar to those of randomized clinical trials that studied fractional flow reserve (FFR). Lesion deferral based on FFR is a very safe strategy, even for lesions located in the proximal anterior descending artery. Randomized controlled studies FAME and DEFER convincingly showed the safety of lesion revascularization...

Debemos tener en cuenta a la isquemia crítica de MM II en el TAVI

Pre-TAVR Revascularization: Angiographic or Physiological?

In patients undergoing transcatheter aortic valve replacement (TAVR), fractional flow reserve (FFR) guided revascularization is associated with favorable results compared against the traditional angiography guided revascularization.  Given the complete lack of randomized studies, this observational study is the best we have to decide how to guide revascularization in patients with symptomatic severe aortic stenosis undergoing...

La ATC es una alternativa válida en el TCI

The Road Towards a “More Perfect” Angioplasty Is Already Being Traveled

The aim of revascularization, whether through angioplasty or surgery, is to restore adequate flow to the myocardium; that much is obvious. However, after millions of “successful” procedures with the best technology applied to drug-eluting stents and optimal medical treatment, we still have a high ratio of patients who experience new events. Could an optimal angiographical...

¿Se debe tener en cuenta el género para revascularizar el tronco?

iFR or FFR Measurements by Sex: Is Either One More Adequate?

According to the post hoc analysis of the DEFINE-FLAIR, patient sex seems to affect instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR) guided revascularization outcomes. Even though this is not specified in the study protocols, it might affect the gold standard for functional lesion assessment.  However, clinical outcomes are similar with both strategies. Therefore,...

Impacto del FFR post stent ¿dato útil o solo una curiosidad?

Discordance Between FFR and iFR. Which Measurement Is More Important?

In the next days, Dr. Seung Hun and colleagues will publish in J Am Coll Cardiol Intv 2019 a study that answers the title question and also brings peace of mind about the decisions we make based on one of these measurements or the other. This study assessed the physiologic characteristics of discordant lesions between...

Highlights TCT 2019

TCT 2019 | PCI in Stable CAD. Prior TAVR, with TAVR or Never?

Courtesy of SBHCI. This interesting study presented at TCT 2019 and simultaneously published in Am J Cardiol tells us PCI in stable coronary artery disease cannot lower risk in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR). Unless patients are symptomatic, most coronary artery lesions do not need revascularization according to researchers....

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