Coronary Stenosis Physiology and Novel Technologies.

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Imaging

Background:

• Accurate functional assessment of coronary artery stenosis is critical for optimal patient management and outcomes.
• Hemodynamic relevance of coronary stenoses is evaluated using coronary flow surrogates like fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR).

Purpose of the Study:

• To provide an overview of FFR and iFR, their clinical relevance, and supporting literature.
• To review novel image-based FFR techniques, such as FFRangio, and their accuracy compared to wire-based methods.
• To discuss the clinical implications of non-invasive functional assessments of coronary artery stenosis.

Main Methods:

• Literature review of studies evaluating FFR, iFR, and image-based FFR techniques.
• Comparison of accuracy between conventional wire-based FFR/iFR and novel non-invasive methods.
• Analysis of clinical outcomes and implications associated with these functional assessments.

Main Results:

• FFR and iFR are established methods for assessing the hemodynamic significance of coronary stenoses.
• Image-based FFR techniques like FFRangio demonstrate comparable accuracy to invasive wire-based methods.
• Non-invasive functional assessments are increasingly important in clinical decision-making.

Conclusions:

• FFR and iFR are essential tools for functional assessment of coronary artery stenosis.
• Non-invasive methods, including image-based FFR, offer a promising alternative to invasive assessments.
• Accurate functional assessment impacts clinical management and patient outcomes.