Fractional Flow Reserve

Traditionally, coronary artery disease was assessed using coronary angiographic guidance. Significant lesions were determined by the coronary angiographer. However, interobserver variability showed a significant limitation of interpretation of coronary angiography. Stent deployment and apposition were also evaluated based on angiographic appearance only. Risk factors for stent thrombosis and in-stent restenosis such as incomplete stent apposition, edge dissection, and thrombus presence were often not detected. However, in the last 10 years, the field of interventional cardiology has benefitted from the use of more objective measures of the severity of coronary artery disease. Fractional flow reserve is calculated by dividing the distal coronary pressure by the proximal coronary pressure during maximal hyperemia this article will discuss the use of fractional flow reserve in determining the severity of coronary artery lesions and whether they should be revascularized.

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