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Nonhyperemic Pressure Ratios-All the Same or Nuanced Differences?
Samineh Sehatbakhsh1, Weijia Li2, Tatsunori Takahashi2
1Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 210th Street, Bronx, NY 10467, USA.
Insights
Fractional flow reserve (FFR) is the standard for assessing coronary artery disease (CAD), but its use is limited. This review explores wire-based alternatives to FFR, discussing their development, evidence, and limitations.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Fractional flow reserve (FFR) is the gold standard for assessing the functional significance of coronary artery disease (CAD).
- Despite strong evidence, FFR adoption is limited by invasive procedures and hyperemia induction.
- Daily practice faces challenges with FFR implementation.
Purpose of the Study:
- To review wire-based alternatives to FFR for assessing CAD.
- To provide insights into the development and clinical evidence of these alternatives.
- To discuss the limitations of current FFR alternatives.
Main Methods:
- Literature review of wire-based FFR alternatives.
- Analysis of development pathways for new technologies.
- Evaluation of clinical evidence and limitations.
Main Results:
- Several wire-based alternatives to FFR have been developed.
- Clinical evidence for these alternatives varies.
- Limitations include technical challenges and incomplete data.
Conclusions:
- Wire-based alternatives offer potential solutions to FFR limitations.
- Further research is needed to establish their role in CAD management.
- These alternatives may improve FFR accessibility and reduce procedural burden.
Abstract:
Fractional flow reserve (FFR) has become the gold standard for invasively assessing the functional significance of coronary artery disease (CAD) to guide revascularization. The amount of evidence supporting the role of FFR in the cardiac catheterization laboratory is large and still growing. However, FFR uptake in the daily practice is limited by a variety of factors such as invasive instrumentation of the coronary artery that requires extra time and need for vasodilator medications for hyperemia. In this review, we describe the details of wire-based alternatives to FFR, providing insights as to their development, clinical evidence, and limitations.
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