Key result
CCTA- and RA-derived FFR provides a less invasive alternative to invasive FFR for identifying lesion-specific ischemia.
Why the study?
Does FFR derived from CCTA and RA using computational fluid dynamics accurately determine lesion-specific ischaemia compared to invasive FFR in patients with coronary artery disease?
Does FFR derived from CCTA and RA using computational fluid dynamics accurately determine lesion-specific ischaemia compared to invasive FFR in patients with coronary artery disease?
Noninvasive FFR derived from CCTA or RA using computational fluid dynamics offers a promising alternative to invasive FFR for identifying ischemia-causing coronary stenoses.
May reduce invasive FFR risks in CAD; leaves open prospective validation before clinical use.
The assessment of functional severity of atherosclerotic stenoses in patients with coronary artery disease by invasive fractional flow reserve (FFR) measurement requires coronary artery cannulation, advancement of a wire and intravenous adenosine infusion with inherent procedure-related risk and costs. Coronary computed tomographic angiography (CCTA) and rotational coronary angiography (RA) have been recently used in conjunction with computational fluid dynamics (CFD) and image-based modelling for the determination of FFR without the need for additional imaging, modification of acquisition protocols or administration of medication. FFR derived from CCTA was demonstrated as superior to measures of CCTA stenosis severity for determination of lesion-specific ischaemia. Estimation of FFR from RA images and CFD provides a less invasive alternative to conventional FFR measurement while estimated values are in agreement with measured values. These new, combined anatomic-functional assessments have the potential to simplify the noninvasive diagnosis of coronary artery disease with a single study to identify patients with ischaemia-causing stenosis who may benefit from revascularisation.
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Pantos et al. (2014) conducted a review in Coronary artery disease. FFR derived from CCTA and rotational angiography using computational fluid dynamics vs. Invasive FFR measurement was evaluated. FFR derived from CCTA and rotational angiography using computational fluid dynamics provides a less invasive alternative to conventional invasive FFR measurement for identifying lesion-specific ischemia.
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