Technical aspects and limitations of fractional flow reserve measurement

Acta Cardiol. 2019 Feb;74(1):9-16. doi: 10.1080/00015385.2018.1444951. Epub 2018 Feb 27.

Abstract

Background: The only indication for coronary revascularization is elimination of ischaemia. Invasive hemodynamic methods (fractional flow reserve - FFR and instantaneous wave-free ratio (iFR) are superior to coronary angiography in detection of lesions causing myocardial ischaemia. Current European guidelines for myocardial revascularization recommend using of FFR for detection of functional assessment of lesions severity in category IA and number of these procedures increases. However, routine usage of these methods requires knowledge of technical requirements and limitations.

Aim: The aim of the study is to summarise good clinical practice for FFR and iFR measurements with explanation of possible technical challenges, that are necessary for increasing of measurement accuracy.

Conclusions: Authors describe frequent technical mistakes and malpractice during invasive assessment of lesion severity in coronary arteries.

Keywords: Fractional flow reserve; coronary artery disease; instantaneous wave-free ratio.

Publication types

  • Review

MeSH terms

  • Cardiac Catheterization / methods*
  • Coronary Angiography / methods*
  • Coronary Artery Disease / diagnosis*
  • Coronary Artery Disease / physiopathology
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / physiopathology*
  • Fractional Flow Reserve, Myocardial / physiology*
  • Humans
  • ROC Curve
  • Reproducibility of Results