Published in:
01-04-2016 | Ischemic Heart Disease (D Mukherjee, Section Editor)
Clinical Application of Fractional Flow Reserve–Guided Percutaneous Coronary Intervention for Stable Coronary Artery Disease
Authors:
Valay Parikh, Kanishk Agnihotri, Sabeeda Kadavath, Nileshkumar J. Patel, J. Dawn Abbott
Published in:
Current Cardiology Reports
|
Issue 4/2016
Login to get access
Abstract
Revascularization in stable ischemic heart disease (SIHD) is indicated in patients on optimal medical therapy with angina and/or demonstrable ischemia and a significant stenosis in one or more epicardial coronary arteries. Angiography alone, however, cannot accurately determine the hemodynamic significance of coronary lesions, particularly those of intermediate stenosis severity. A lesion may appear significant on coronary angiogram but may not have functional significance. Percutaneous coronary intervention (PCI) of functionally insignificant coronary artery lesions may have serious consequences; therefore, judicious decision-making in the cardiac catheterization laboratory is indicated. For this reason, it is becoming increasingly important to show that a stenosis is capable to induce myocardial ischemia prior to intervention. Fractional flow reserve (FFR) has emerged as a useful tool for this purpose. In this review, we will briefly discuss the principle of FFR, current evidence and rationale supporting its use, and comparison with other modalities.