scholarly journals P5502Comparison of accuracy of fractional flow reserve using optical sensor wire to conventional pressure wire

2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
R Tateishi ◽  
S Kimura ◽  
T Kawakami ◽  
N Kanehama ◽  
S Tachibana ◽  
...  
Keyword(s):  
Fractional Flow Reserve ◽  
Optical Sensor ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Pressure Wire

Fractional flow reserve in clinical practice: from wire-based invasive measurement to image-based computation

2019 ◽  
Vol 41 (34) ◽  
pp. 3271-3279 ◽  
Author(s):  
Shengxian Tu ◽  
Jelmer Westra ◽  
Julien Adjedj ◽  
Daixin Ding ◽  
Fuyou Liang ◽  
...  
Keyword(s):  
Fractional Flow Reserve ◽  
Diagnostic Methods ◽  
Functional Evaluation ◽  
Fractional Flow ◽  
Catheterization Laboratory ◽  
Flow Reserve ◽  
Pressure Wire ◽  
Stenosis Severity ◽  
Procedural Guidance ◽  
Invasive Measurement

Abstract Fractional flow reserve (FFR) and instantaneous wave-free ratio are the present standard diagnostic methods for invasive assessment of the functional significance of epicardial coronary stenosis. Despite the overall trend towards more physiology-guided revascularization, there remains a gap between guideline recommendations and the clinical adoption of functional evaluation of stenosis severity. A number of image-based approaches have been proposed to compute FFR without the use of pressure wire and induced hyperaemia. In order to better understand these emerging technologies, we sought to highlight the principles, diagnostic performance, clinical applications, practical aspects, and current challenges of computational physiology in the catheterization laboratory. Computational FFR has the potential to expand and facilitate the use of physiology for diagnosis, procedural guidance, and evaluation of therapies, with anticipated impact on resource utilization and patient outcomes.

Fractional Flow Reserve: Who Needs the Pressure Wire?

1999 ◽  
Vol 12 (6) ◽  
pp. 425-430
Author(s):  
JOZEF BARTUNEK ◽  
NICO H. J. PIJLS ◽  
G. JAN WILLEM BECH ◽  
BERNARD BRUYNE
Keyword(s):  
Fractional Flow Reserve ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Pressure Wire

P1250Validation of quantitative flow reserve and residual quantitative flow reserve to predict fractional flow reserve post stenting from the DOCTORS study population

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
B G Guillon ◽  
V R Rubimbura ◽  
S F Fournier ◽  
N A Amabile ◽  
C C P Chi Pan ◽  
...  
Keyword(s):  
Fractional Flow Reserve ◽  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Mean Value ◽  
Fractional Flow ◽  
Mean Values ◽  
Flow Reserve ◽  
Pressure Wire ◽  
Study Population ◽  
Quantitative Flow

Abstract Background Quantitative flow reserve (QFR) is a computation of fractional flow reserve (FFR) based on angiography without use of a pressure wire. The ability to predict post-PCI FFR using residual QFR after virtual stenting (pre-PCI), and using QFR (post-PCI) remains unknown. We sought to evaluate the correlation and diagnosis accuracy of residual QFR and post-PCI QFR to predict post-PCI FFR. Methods From the DOCTORS (Does Optical Coherence Tomography Optimize Results of Stenting) study population, we blindly analyzed the following from angiography, and compared them to post-PCI FFR: pre-PCI residual contrast QFR (cQFR) and fixed QFR (fQFR), and post-PCI cQFR and fQFR. Results 93 post-PCI QFR measurements and 84 residual QFR measurements were compared to post-PCI FFR measurements in 93 patients. Compared to the post-PCI FFR mean value of 0.92±0.05, mean values of residual cQFR, residual fQFR, post-PCI cQFR and post-PCI fQFR were, respectively: 0.94±0.05, 0.93±0.05, 0.93±0.06 and 0.93±0.05 (p values >0.05 for all pairs except for residual cQFR versus FFR (p=0.01)). Pearson correlation coefficients of residual cQFR, residual fQFR, post-PCI cQFR and post-PCI fQFR compared with post-PCI FFR were, respectively: 0.62, (95% CI: 0.46–0.73); 0.61, (95% CI: 0.45–0.73); 0.75, (95% CI: 0.64–0.83) and 0.73, (95% CI: 0.62–0.81). Area under the curves for these indices with a post-PCI FFR cutoff value of 0.90 were, respectively: 0.79, 0.78, 0.85 and 0.84. Conclusions cQFR and fQFR correlated well and had similar diagnostic performance. Pre-PCI QFR analysis with virtual PCI, and post-PCI QFR analysis, correlated well with post-PCI FFR, and had similar diagnostic accuracy. Further studies are needed to prospectively validate a QFR-guided PCI strategy.

scholarly journals Novel Indices of Coronary Physiology

2020 ◽  
Vol 13 (4) ◽  
Author(s):  
Giovanni Luigi De Maria ◽  
Hector M. Garcia-Garcia ◽  
Roberto Scarsini ◽  
Alexandre Hideo-Kajita ◽  
Nieves Gonzalo López ◽  
...  
Keyword(s):  
Fractional Flow Reserve ◽  
Special Focus ◽  
Fractional Flow ◽  
Procedural Cost ◽  
Flow Reserve ◽  
Pressure Wire ◽  
Pros And Cons ◽  
Artery Disease ◽  
Development Alternatives ◽  
Near Future

Fractional flow reserve is the current invasive gold standard for assessing the ischemic potential of an angiographically intermediate coronary stenosis. Procedural cost and time, the need for coronary vessel instrumentation, and the need to administer adenosine to achieve maximal hyperemia remain integral components of invasive fractional flow reserve. The number of new alternatives to fractional flow reserve has proliferated over the last ten years using techniques ranging from alternative pressure wire metrics to anatomic simulation via angiography or intravascular imaging. This review article provides a critical description of the currently available or under-development alternatives to fractional flow reserve with a special focus on the available evidence, pros, and cons for each with a view towards their clinical application in the near future for the functional assessment of coronary artery disease.

scholarly journals Comparison of Machine Learning Computed Tomography-Based Fractional Flow Reserve and Coronary CT Angiography-Derived Plaque Characteristics with Invasive Resting Full-Cycle Ratio

2020 ◽  
Vol 9 (3) ◽  
pp. 714
Author(s):  
Stefan Baumann ◽  
Markus Hirt ◽  
Christina Rott ◽  
Gökce H. Özdemir ◽  
Christian Tesche ◽  
...  
Keyword(s):  
Machine Learning ◽  
Computed Tomography ◽  
Coronary Artery ◽  
Fractional Flow Reserve ◽  
Coronary Stenosis ◽  
Fractional Flow ◽  
Luminal Diameter ◽  
Coronary Computed Tomography ◽  
Flow Reserve ◽  
Pressure Wire

Background: The aim is to compare the machine learning-based coronary-computed tomography fractional flow reserve (CT-FFRML) and coronary-computed tomographic morphological plaque characteristics with the resting full-cycle ratio (RFRTM) as a novel invasive resting pressure-wire index for detecting hemodynamically significant coronary artery stenosis. Methods: In our single center study, patients with coronary artery disease (CAD) who had a clinically indicated coronary computed tomography angiography (cCTA) and subsequent invasive coronary angiography (ICA) with pressure wire-measurement were included. On-site prototype CT-FFRML software and on-site CT-plaque software were used to calculate the hemodynamic relevance of coronary stenosis. Results: We enrolled 33 patients (70% male, mean age 68 ± 12 years). On a per-lesion basis, the area under the receiver operating characteristic curve (AUC) of CT-FFRML (0.90) was higher than the AUCs of the morphological plaque characteristics length/minimal luminal diameter4 (LL/MLD4; 0.80), minimal luminal diameter (MLD; 0.77), remodeling index (RI; 0.76), degree of luminal diameter stenosis (0.75), and minimal luminal area (MLA; 0.75). Conclusion: CT-FFRML and morphological plaque characteristics show a significant correlation to detected hemodynamically significant coronary stenosis. Whole CT-FFRML had the best discriminatory power, using RFRTM as the reference standard.

Fractional Flow Reserve Estimation in Coronary Arteries by Forward Geometrical Modeling

2013 ◽  
Author(s):  
Jelle T. C. Schrauwen ◽  
Jolanda J. Wentzel ◽  
Anton F. W. van der Steen ◽  
Frank J. H. Gijsen
Keyword(s):  
Clinical Practice ◽  
Pressure Drop ◽  
Coronary Arteries ◽  
Fractional Flow Reserve ◽  
Coronary Stenosis ◽  
Fractional Flow ◽  
Reserve Estimation ◽  
Important Indicator ◽  
Flow Reserve ◽  
Pressure Wire

Fractional Flow Reserve (FFR) is an important indicator for the hemodynamic significance of a coronary stenosis [1]. The FFR is defined as the pressure drop over the stenosis under hyperemia. The pressure drop, and thus the FFR, depends on both the geometry and flow. In clinical practice, the FFR is measured with a pressure wire under administration of adenosine and intervention is warranted if the FFR is below 0.8.

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