Tag Archives: iFR

El acceso radial se asocia a menor mortalidad y menor sangrado en los pacientes cursando un infarto con supradesnivel del segmento ST que reciben angioplastia primaria.

Large Differences between Focal and Diffuse Patterns of Stable CAD

Large Differences between Focal and Diffuse Patterns of Stable CAD

PCI is far more successful at reducing ischemia when treating focal stable coronary artery disease (CAD). However, there were no differences in symptoms between both types of CAD.  Physiological assessment with pressure wire pullback can be used to distinguish focal vs diffuse CAD, even though the relevance of this distinction has not been looked at

IVUS vs OCT para guiar la angioplastia ¿Cuál elegir?

IVUS vs iFR for Left Main Decision Making

No decision on the coronary tree has more impact than left main intervention. This makes interventionists prone to over and underestimation of angiographic imaging. In other words, in real life we never report on angiograms showing moderate left main lesions.   This reality should be looked into, since operating or intervening moderate left main lesions on

FFR and iFR Discordance in up to 20% of Cases: Which One Should Inform Our Decisions?

Invasive functional measurement of intermediate lesions has become the gold standard to define revascularization. Due to its favorable long-term prognostic value, fractional flow reserve (FFR) is the reference used to compare all others. Recently, new nonhyperemic indexes, measured in a specific diastolic period, have emerged. Among them, the one with the most accumulated evidence is

TCT 2020 | Nueva información sobre el valor del FFR antes y después de la angioplastia

TCT 2020 | Fewer Symptoms and Events when Optimizing with iFR

Symptomatic patients undergoing PCI with no residual ischemia confirmed by iFR have superior symptom improvement at one year vs. patients who did not receive the optimization.  In addition to symptoms, patients receiving iFR optimization (final value ≥ 0.95) presented lower cardiac mortality, spontaneous MI or clinically justified revascularization vs. patients with <0.95 final value.  

EuroPCR 2020 | Deferral Based on iFR vs. FFR: Are They Equivalent or Is There a New “Gold Standard”?

Age may impact results when making an angioplasty choice based on fractional flow reserve (FFR) vs. instantaneous wave-free ratio (iFR). After 2 years of follow-up, patients whose treatment of intermediate lesions was deferred based on functional testing had similar outcomes regardless of whether this decision was informed by FFR or iFR. However, iFR performance was constant,

¿Es seguro utilizar iFR para diferir lesiones del tronco de la coronaria izquierda?

Is the Use of iFR for the Deferral of Left Main Coronary Artery Lesions Safe?

Deferral of left main coronary artery lesions using instantaneous wave-free ratio (iFR) seems to be safe. At the least, patients with deferred lesions had similar long-term prognosis to that of patients who underwent revascularization based on that same indicator. Left main coronary artery lesions were universally excluded from studies including medical treatment among the therapeutic

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

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

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