Fractional flow reserve-guided myocardial revascularization

Legutko, Jacek; Jąkała, Jacek; Mrevlje, Blaž; Bartuś, Stanisław; Dudek, Dariusz

doi:10.5114/pwki.2011.24741

Cited by 5 publications

(3 citation statements)

References 20 publications

(30 reference statements)

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“…The Fractional Flow Reserve versus Angiography For Multivessel Evaluation (FAME) studies have found superior clinical outcomes with FFR-based PCI compared with conventional angiography-based treatment [ 5 ]. But for stable CAD patients, advocates for PCI continue to search for sound evidence that revascularization improves prognosis, though it is well established that PCI in patients with stable but symptomatic CAD relieves angina and improves quality of life [ 47 – 49 ]. Thus, De Bruyne et al .…”

Section: Clinical Application Of Fractional Flow Reservementioning

confidence: 99%

State of the art paper Comprehensive assessment of coronary fractional flow reserve

Qi¹,

Fan²,

Zhu³

et al. 2015

aoms

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Fractional flow reserve (FFR) is considered nowadays as the gold standard for invasive assessment of physiologic stenosis significance and an indispensable tool for decision-making in coronary revascularization. Robust studies have shown that FFR is more effective in accurately identifying which lesions should be stented, and revascularization guided by FFR improves the outcome of coronary artery disease in patients. Therefore, FFR has been upgraded to a class A recommendation in current guidelines when the ischemic potential for specific target lesions is controversial. This article reviews the laboratory practice, functional evaluation of FFR as a gold standard and its emerging clinical application. In addition, novel noninvasive technologies of FFR measurement are discussed in depth.

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Section: Clinical Application Of Fractional Flow Reservementioning

confidence: 99%

State of the art paper Comprehensive assessment of coronary fractional flow reserve

Qi¹,

Fan²,

Zhu³

et al. 2015

aoms

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“…1 Although revascularization of intermediate and ischemia-producing lesions may improve patient symptoms and clinical outcomes, the treatment of non-flow-limiting coronary stenoses is of no proven benefit. 4,5 Recently, a promising method of advanced quantitative coronary angiography (A-QCA) including the mathematically derived Poiseuillebased coronary index [defined as the ratio of lesion length to the fourth power of the minimal lumen diameter (MLD)] has been suggested as an accurate estimate for detection of significant hemodynamic effects in intermediate stenoses as defined by angiographic criteria. 4,5 Recently, a promising method of advanced quantitative coronary angiography (A-QCA) including the mathematically derived Poiseuillebased coronary index [defined as the ratio of lesion length to the fourth power of the minimal lumen diameter (MLD)] has been suggested as an accurate estimate for detection of significant hemodynamic effects in intermediate stenoses as defined by angiographic criteria.…”

mentioning

confidence: 99%

Advanced 2-Dimensional Quantitative Coronary Angiographic Analysis for Prediction of Fractional Flow Reserve in Intermediate Coronary Stenoses

Opolski¹,

Pręgowski²,

Kruk³

et al. 2014

Journal of Thoracic Imaging

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“…Currently, the borderline coronary artery stenoses are most commonly assessed by intravascular ultrasound and fractional flow reserve (FFR) alongside with quantitative coronary angiography [2]. FFR measurement, as performed by pressure wire (PW), requires its multiple removals during FFR and percutaneous coronary intervention (PCI), and results in a relatively high signal drift with loss of accuracy.…”

mentioning

confidence: 99%

Fractional flow reserve measurement modification with monorail pressure catheter

Jędrychowska¹,

Januszek²,

Rzeszutko³

et al. 2016

Cardiol J.

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A number of symptomatic patients with coronary artery disease undergo revascularization without definite evidence that particular coronary stenosis is responsible for their symptoms [1]. Currently, the borderline coronary artery stenoses are most commonly assessed by intravascular ultrasound and fractional flow reserve (FFR) alongside with quantitative coronary angiography [2]. FFR measurement, as performed by pressure wire (PW), requires its multiple removals during FFR and percutaneous coronary intervention (PCI), and results in a relatively high signal drift with loss of accuracy. The novel exchange microcatheter (RXi) was invented to assess FFR in a safer mode [3,4].A 61-year-old man was admitted to hospital with exertional stenocardia. The patient underwent myocardial infarction in 1988 and coronary artery bypass grafting operation in 1999. Angiography revealed total occlusion of the left anterior descending artery (LAD), as previously. In the right coronary artery (RCA) occurred disseminated, multi-segmental stenoses up to 40% with borderline stenosis of 60% in the distal portion (Fig. 1A). The aorto-marginal saphenous vein Cine image of RCA and the Acist Navvus microcatheter during the measurement, and its distal part with the radiopaque marker (labeled with white arrow); C. Cine image of RCA after angioplasty with stent deployment (marked with white arrow); D. Fractional flow reserve (FFR) of distal part of RCA before stent implantation. E: FFR of distal part of RCA after stent implantation; Pa -pressure proximal to the lesion; Pd -pressure distal to the lesion; Pv -coronary venous pressure.

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Fractional flow reserve-guided myocardial revascularization

Cited by 5 publications

References 20 publications

State of the art paper Comprehensive assessment of coronary fractional flow reserve

State of the art paper Comprehensive assessment of coronary fractional flow reserve

Advanced 2-Dimensional Quantitative Coronary Angiographic Analysis for Prediction of Fractional Flow Reserve in Intermediate Coronary Stenoses

Fractional flow reserve measurement modification with monorail pressure catheter

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