Fractional Flow Reserve

Angiographic results alone can guide the decision to perform a percutaneous coronary intervention (PCI). Angiography is used to visually assess the coronary anatomy and determine the degree of stenosis, plaque, or blockage in the coronary artery. The blockage creates visual irregularities of the inner diameter of coronary vessels on angiography, and those irregularities are quantified using a percentage. This percentage correlates with the degree of blockage of the artery. The degree of blockage is usually quantified with a percentage and categorized into mild, moderate/intermediate, or severe.

The assessment of intermediate blockages in coronary artery disease has long been a challenge for interventional cardiologists to determine the appropriate use of angioplasty and stenting. Fractional Flow Reserve (FFR) offers yet another tool to assist in identifying those intermediate blockages. The goal of angioplasty and stenting in the coronary arteries is to increase blood flow to the heart and relieve chest pain. However, studies have shown that if a functional measurement, such as FFR, shows that the flow is not significantly blocked, the blockage or lesion does not need to be revascularized (angioplasty/stenting), and a physician can treat the patient with medical therapy safely. FFR is a guide wire-based procedure that accurately measures blood pressure and flow through an isolated coronary artery segment. A physician can do FFR through a standard diagnostic catheter during a coronary angiogram or cardiac catheterization. FFR has been demonstrated to be useful in assessing “intermediate” blockages (coronary artery disease) to determine the need for angioplasty or stenting (See Image. Fractional Flow Reserve Procedure).