Key result
Angiography-based fractional flow reserve indices demonstrate high diagnostic accuracy and serve as excellent alternatives to invasive pressure-wire-based FFR for assessing coronary stenoses.
Why the study?
Three-dimensional quantitative coronary angiography-based methods of FFR derivation have emerged as an appealing alternative to conventional pressure-wire physiological lesion assessment with the potential to extend physiology use.
Do angiography-based FFR methods provide accurate physiological lesion assessment compared to invasive FFR in patients with coronary artery disease?
Do angiography-based FFR methods provide accurate physiological lesion assessment compared to invasive FFR in patients with coronary artery disease?
Angiography-based FFR methods offer a highly accurate, wire-free alternative to invasive FFR for physiological lesion assessment, with emerging evidence suggesting improved clinical outcomes compared to angiography-guided PCI.
May support wire-free FFR use in coronary assessment; leaves open need for randomized outcome trials before routine adoption.
PURPOSE OF REVIEW: Three-dimensional quantitative coronary angiography-based methods of fractional flow reserve (FFR) derivation have emerged as an appealing alternative to conventional pressure-wire-based physiological lesion assessment and have the potential to further extend the use of physiology in general. Here, we summarize the current evidence related to angiography-based FFR and perspectives on future developments. RECENT FINDINGS: Growing evidence suggests good diagnostic performance of angiography-based FFR measurements, both in chronic and acute coronary syndromes, as well as in specific lesion subsets, such as long and calcified lesions, left main coronary stenosis, and bifurcations. More recently, promising results on the superiority of angiography-based FFR as compared to angiography-guided PCI have been published. Currently available angiography -FFR indices proved to be an excellent alternative to invasive pressure wire-based FFR. Dedicated prospective outcome data comparing these indices to routine guideline recommended PCI including the use of FFR are eagerly awaited.
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Scoccia et al. (2022) conducted a review in Coronary artery disease. Angiography-based Fractional Flow Reserve (FFR) vs. Invasive pressure-wire-based FFR was evaluated. Angiography-based fractional flow reserve indices demonstrate high diagnostic accuracy and serve as excellent alternatives to invasive pressure-wire-based FFR for assessing coronary stenoses.
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