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Fractional Flow Reserve

Fractional Flow Reserve

Our Cath Lab has another Important Modality i.e. Fractional Flow reserve (FFR) & Resting Full Cycle Ratio (RFR) estimation with the help of QUANTIEN FFR Console from Abbott Vascular. FFR is considered the Gold Standard for estimation of severity of coronary blockages which can be misleading by visual estimation alone.

Traditionally the percentage blockage in coronaries are determined only by visual estimation. Few computerised tools are also available for the same purpose but are not being used routinely. Visual estimation is a crude method and can lead to significant errors in decision making. This can lead to under or over estimation of disease which can result in unnecessary treatment of blockage not requiring treatment or vice versa. There is no versatile tool available as of now for exact estimation of percent blockage as cornaries are three dimensional structures and we are seeing them in two dimensions.

FFR or Fractional Flow Reserve is one such powerful tool for exact estimation of significance of coronary blockage. This does not provide a percent estimation of blockage but rather provides inputs that a particular blockage is interfering with blood supply of heart or not. This works on the principle of pressure difference across the blockage in coronary arteries and a pressure difference of 20 percent is considered significant requiring treatment by angioplasty or bypass. Both type of clinical scenarios are common in FFR. An 80 percent block by visual estimate in coronary artery can turn out to be normal on FFR and does not require treatment by angioplasty. Similarly a 50 percent block by visual estimate can turn out to be significant requiring treatment.

Therefore FFR is one such scientifically proven tool which should be used in most of the coronary angioplasties except in situation of heart attack