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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Clinical Outcomes Data for Instantaneous Wave-Free Ratio-Guided Percutaneous Coronary Intervention

Masood Younus1, Arnold H Seto2

  • 1Department of Medicine, University of California, 101 The City Drive South, Orange, CA 92868, USA.

Interventional Cardiology Clinics
|March 6, 2019
PubMed

Insights

Instantaneous wave-free ratio (iFR) offers a vasodilator-free method for assessing coronary blood flow and guiding revascularization decisions. This approach reduces adverse effects, shortens procedures, and lowers revascularization rates, proving beneficial in complex cases.

Area of Science:

  • Cardiovascular physiology
  • Interventional cardiology

Background:

  • The instantaneous wave-free ratio (iFR) is a vasodilator-free physiological index.
  • It is utilized in clinical practice for revascularization decision-making in coronary artery disease.

Purpose of the Study:

  • To evaluate the clinical utility and outcomes associated with iFR-based revascularization.
  • To explore the predictive value of iFR-pullback for post-intervention outcomes.
  • To identify patient subgroups where iFR may offer particular advantages.

Main Methods:

  • Assessment of coronary blood flow using the iFR technique.
  • Comparison of outcomes between iFR-guided and other revascularization strategies.
  • Utilization of iFR-pullback for predicting post-percutaneous coronary intervention (PCI) outcomes.

Main Results:

  • iFR-based revascularization is associated with reduced adverse effects from vasodilators.
  • Shorter procedure times and lower revascularization rates are observed with iFR guidance.
  • iFR-pullback demonstrates predictive capability for post-PCI physiologic outcomes in tandem and diffuse lesions.

Conclusions:

  • iFR is a valuable tool for revascularization planning, offering a safe alternative to vasodilator-dependent methods.
  • iFR is particularly useful in patients with adenosine resistance or contraindications, and in those with multivessel or serial lesions.
  • The integration of iFR, with or without fractional flow reserve (FFR), enhances revascularization planning.

Keywords:
Instantaneous wave-free ratioPCI outcomesiFR

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