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Published online: 2019-03-08
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Alternative methods for functional assessment of intermediate coronary lesions

Martyna Zaleska, Łukasz Kołtowski, Jakub Maksym, Mariusz Tomaniak, Maksymilian Opolski, Janusz Kochman
DOI: 10.5603/CJ.a2019.0027
·
Pubmed: 30912574

open access

Ahead of print
Review articles
Published online: 2019-03-08

Abstract

Wire-based fractional flow reserve (FFR) is a diagnostic tool used to evaluate the ischemic burden of coronary lesions. Large-scale studies have shown that FFR-guided revascularization is associated with better clinical outcomes. However, wide adoption of this technology is limited due to the considerable cost, additional time needed for set-up and performance of the measurement as well as the invasiveness of the procedure which requires pressure wire placement across the lesion into the distal segment of the coronary artery. To overcome these limitations new, promising, and less-/non-invasive methods were developed. These methods are based on computational fluid dynamics analysis and three-dimensional lumen reconstruction. The aim of this paper is to review scientific evidence supporting the clinical safety and efficacy of these techniques, such as instantaneous wave-free ratio, quantitative flow ratio and FFR calculated from computed tomographic angiography.

Abstract

Wire-based fractional flow reserve (FFR) is a diagnostic tool used to evaluate the ischemic burden of coronary lesions. Large-scale studies have shown that FFR-guided revascularization is associated with better clinical outcomes. However, wide adoption of this technology is limited due to the considerable cost, additional time needed for set-up and performance of the measurement as well as the invasiveness of the procedure which requires pressure wire placement across the lesion into the distal segment of the coronary artery. To overcome these limitations new, promising, and less-/non-invasive methods were developed. These methods are based on computational fluid dynamics analysis and three-dimensional lumen reconstruction. The aim of this paper is to review scientific evidence supporting the clinical safety and efficacy of these techniques, such as instantaneous wave-free ratio, quantitative flow ratio and FFR calculated from computed tomographic angiography.

Get Citation

Keywords

coronary angiography, quantitative flow ratio, computational fluid dynamics, fractional flow reserve

About this article
Title

Alternative methods for functional assessment of intermediate coronary lesions

Journal

Cardiology Journal

Issue

Ahead of print

Published online

2019-03-08

DOI

10.5603/CJ.a2019.0027

Pubmed

30912574

Keywords

coronary angiography
quantitative flow ratio
computational fluid dynamics
fractional flow reserve

Authors

Martyna Zaleska
Łukasz Kołtowski
Jakub Maksym
Mariusz Tomaniak
Maksymilian Opolski
Janusz Kochman

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