Simplified Models of Non-Invasive Fractional Flow Reserve Based on CT Images

Fractional flow reserve (FFR) has been shown to improve outcomes when used to guide percutaneous coronary intervention (PCI). There have been two proposed cut-off points for FFR. The first was derived by comparing FFR against a series of non-invasive tests, with a value of ≤0.75 shown to predict a positive ischaemia test. It was then shown in the DEFER study that a vessel FFR value of ≥0.75 was associated with safe deferral of PCI. During the validation phase, a ‘grey zone’ for FFR values of between 0.76 and 0.80 was demonstrated, where a positive non-invasive test may still occur, but sensitivity and specificity were sub-optimal. Clinical judgement was therefore advised for values in this range. The FAME studies then moved the FFR cut-off point to ≤0.80, with a view to predicting outcomes. The ≤0.80 cut-off point has been adopted into clinical practice guidelines, whereas the lower value of ≤0.75 is no longer widely used. Here, the authors discuss the data underpinning these cut-off values and the practical implications for their use when using FFR guidance in PCI.

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Non-invasive fractional flow reserve (FFRCT) in the evaluation of acute chest pain – Concepts and first experiences

European Journal of Radiology ◽

10.1016/j.ejrad.2021.109633 ◽

2021 ◽

Vol 138 ◽

pp. 109633

Author(s):

Andreas M. Fischer ◽

Marly van Assen ◽

U. Joseph Schoepf ◽

Andrew J. Matuskowitz ◽

Akos Varga-Szemes ◽

...

Keyword(s):

Chest Pain ◽

Fractional Flow Reserve ◽

Acute Chest Pain ◽

Fractional Flow ◽

Non Invasive ◽

Flow Reserve

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NON-INVASIVE FRACTIONAL FLOW RESERVE ASSESSMENT BASED ON MULTI-SLICE COMPUTED TOMOGRAPHY FIVE YEAR AFTER ABSORB BIORESORBABLE SCAFFOLD IMPLANTATION

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(12)60164-8 ◽

2012 ◽

Vol 59 (13) ◽

pp. E163

Author(s):

Yoshinobu Onuma ◽

Koen Nieman ◽

Patrick Serruys

Keyword(s):

Computed Tomography ◽

Fractional Flow Reserve ◽

Fractional Flow ◽

Bioresorbable Scaffold ◽

Non Invasive ◽

Flow Reserve

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Numerical simulation of the fractional flow reserve (FFR)

Mathematical Modelling of Natural Phenomena ◽

10.1051/mmnp/2018069 ◽

2018 ◽

Vol 13 (6) ◽

pp. 57 ◽

Cited By ~ 1

Author(s):

Keltoum Chahour ◽

Rajae Aboulaich ◽

Abderrahmane Habbal ◽

Cherif Abdelkhirane ◽

Nejib Zemzemi

Keyword(s):

Fractional Flow Reserve ◽

Flow Model ◽

Rigid Wall ◽

Fractional Flow ◽

Wall Model ◽

Factors Affecting ◽

Non Invasive ◽

Flow Reserve ◽

Weakly Coupled ◽

Preliminary Study

The fractional flow reserve (FFR) provides an efficient quantitative assessment of the severity of a coronary lesion. Our aim is to address the problem of computing non-invasive virtual fractional flow reserve (VFFR). In this paper, we present a preliminary study of the main features of flow over a stenosed coronary arterial portion, in order to enumerate the different factors affecting the VFFR. We adopt a non-Newtonian flow model and we assume that the two-dimensional (2D) domain is rigid in a first place. In a second place, we consider a simplified weakly coupled FSI model in order to take into account the infinitesimal displacements of the upper wall. A 2D finite element solver was implemented using Freefem++. We computed the VFFR profiles with respect to different lesion parameters and compared the results given by the rigid wall model to those obtained for the elastic wall one.

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