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Fractional flow reserve-guided treatment in coronary artery disease: Clinical practice

Mikołaj Błaziak1, Szymon Urban1, Maksym Jura1

  • 1Student Scientific Organization, Department of Heart Diseases, Wroclaw Medical University, Poland.

Advances in Clinical and Experimental Medicine : Official Organ Wroclaw Medical University
|September 12, 2021
PubMed

Insights

Fractional flow reserve (FFR) helps determine the functional significance of coronary artery blockages, guiding revascularization decisions. This review examines long-term outcomes and challenging clinical scenarios for FFR-guided treatment.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Physiology

Background:

  • Assessing moderate coronary stenoses for functional severity is clinically challenging.
  • Coronary angiography has limitations in detecting myocardial ischemia, necessitating advanced diagnostic tools.
  • Fractional flow reserve (FFR) quantifies hemodynamic significance of coronary lesions.

Purpose of the Study:

  • To review the evidence supporting FFR implementation in clinical practice.
  • To analyze long-term outcomes of FFR-guided revascularization strategies.
  • To discuss challenging clinical cases and interpretation issues in FFR assessment.

Main Methods:

  • Literature review focusing on FFR-driven treatment and long-term patient follow-up.
  • Analysis of published data on the diagnostic accuracy and clinical utility of FFR.
  • Case-based discussion of borderline FFR values, comorbidities, and anatomical risk locations.

Main Results:

  • FFR is a guideline-supported method for evaluating lesion significance.
  • FFR-guided treatment demonstrates favorable long-term outcomes in selected patients.
  • Interpretation of FFR can be complex in specific clinical contexts.

Conclusions:

  • FFR plays a crucial role in identifying patients who benefit from revascularization.
  • Evidence supports the integration of FFR into daily clinical practice for stenosis assessment.
  • Further clarification is needed for challenging FFR interpretations in complex cases.

Keywords:
coronary artery disease (CAD)fractional flow reserve (FFR)grey zonemedical therapyrevascularization

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