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Current Cardiovascular Imaging Reports
Published in: Current Cardiovascular Imaging Reports 8/2020

01-08-2020 | Computed Tomography | Intravascular Imaging (A. G. Truesdell, Section Editor)

Contrast Fractional Flow Reserve (cFFR) and Computed Tomography Fractional Flow Reserve (CT-FFR) Guidance for Percutaneous Coronary Intervention (PCI)

Authors: Aravdeep Jhand, Paul C. Gordon, Barry L. Sharaf, Arnold H. Seto, Amit P. Amin, Srihari S. Naidu, Andrew M. Goldsweig

Published in: Current Cardiovascular Imaging Reports | Issue 8/2020

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Abstract

Purpose of Review

In this review, we summarize both contrast fractional flow reserve (cFFR) and computed tomography fractional flow reserve (CT-FFR) as novel modalities to evaluate the hemodynamic significance of coronary artery stenoses and to guide percutaneous coronary intervention (PCI).

Recent Findings

Implementation of cFFR can reduce the time, cost, effort, and patient discomfort associated with traditional adenosine FFR. Clinical outcomes following cFFR-guided revascularization are currently under investigation. Emerging data on the use of CT-FFR in patients with acute coronary syndromes may increase the use of this technology in acute settings, while virtual stenting applications to model the hemodynamic results of stent placement may help optimize PCI planning.

Summary

Using contrast media already available for traditional angiography, cFFR yields results that are highly reproducible and correlate more closely with traditional adenosine FFR than the distal/aortic pressure ratio (Pd/Pa) or the instantaneous wave-free ratio (iFR). Based upon computational fluid dynamics, CT-FFR provides a non-invasive estimate of the traditional adenosine FFR and predicts ischemia more accurately than nuclear imaging. Therefore, CT-FFR has begun to take on a gatekeeper role to minimize unnecessary invasive angiography.
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Metadata
Title
Contrast Fractional Flow Reserve (cFFR) and Computed Tomography Fractional Flow Reserve (CT-FFR) Guidance for Percutaneous Coronary Intervention (PCI)
Authors
Aravdeep Jhand
Paul C. Gordon
Barry L. Sharaf
Arnold H. Seto
Amit P. Amin
Srihari S. Naidu
Andrew M. Goldsweig
Publication date
01-08-2020
Publisher
Springer US
Published in
Current Cardiovascular Imaging Reports / Issue 8/2020
Print ISSN: 1941-9066
Electronic ISSN: 1941-9074
DOI
https://doi.org/10.1007/s12410-020-09543-1

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