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Use of the Instantaneous Wave-free Ratio or Fractional Flow Reserve in PCI

by Yokoi, Hiroyoshi , Going, Olaf , Matsuo, Hitoshi , Serruys, Patrick , Sapontis, James , Sharp, Andrew S.P , Kharbanda, Rajesh K , Lehman, Sam J , Vrints, Christiaan J , Canas Silva, Pedro , Härle, Tobias , Doh, Joon-Hyung , Krackhardt, Florian , Al-Lamee, Rasha , Meuwissen, Martijin , Talwar, Suneel , Altman, John , Laine, Mika , Piek, Jan J , Nam, Chang-Wook , Nijjer, Sukhjinder S , Samady, Habib , Walters, Darren , Davies, Justin E , Seto, Arnold H , Patel, Manesh R , Singh, Jasvindar , Jeremias, Allen , Koo, Bon-Kwon , Tang, Kare , Erglis, Andrejs , Escaned, Javier , Vinhas, Hugo , Indolfi, Ciro , Ribichini, Flavo , Dehbi, Hakim-Moulay , Di Mario, Carlo , Hellig, Farrel , Petraco, Ricardo , Niccoli, Giampaolo , Shin, Eun-Seok , Takashima, Hiroaki , Gerber, Robert T , Malik, Iqbal S , Bojara, Waldemar , van Royen, Niels , Khashaba, Ahmed , Sezer, Murat , Tanaka, Nobuhiro , Baptista, Sérgio B , Bhindi, Ravinay , Sen, Sayan , Brugaletta, Salvatore , Kikuta, Yuetsu , Alghamdi, Ali , Alegria-Barrero, Eduardo , Van Belle, Eric , Janssens, Luc

in Acute Coronary Syndrome - diagnostic imaging / Acute Coronary Syndrome - physiopathology / Aged / Angina Pectoris - diagnostic imaging / Angina Pectoris - physiopathology / Angioplasty / Cardiology / Cardiovascular disease / Cardiovascular Diseases - mortality / Clinical outcomes / Clinical trials / Coronary Angiography / Coronary artery / Coronary Stenosis - diagnostic imaging / Coronary Stenosis - physiopathology / Coronary Stenosis - therapy / Female / Follow-Up Studies / Fractional Flow Reserve, Myocardial / Humans / Kaplan-Meier Estimate / Male / Middle Aged / Myocardial Infarction - epidemiology / Patients / Percutaneous Coronary Intervention - methods / Retreatment / Severity of Illness Index

2017

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2017

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2017

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Journal Article

Use of the Instantaneous Wave-free Ratio or Fractional Flow Reserve in PCI

Yokoi, Hiroyoshi,

Going, Olaf,

Matsuo, Hitoshi,

Serruys, Patrick,

Sapontis, James,

Sharp, Andrew S.P,

Kharbanda, Rajesh K,

Lehman, Sam J,

Vrints, Christiaan J,

Canas Silva, Pedro,

Härle, Tobias,

Doh, Joon-Hyung,

Krackhardt, Florian,

Al-Lamee, Rasha,

Meuwissen, Martijin,

Talwar, Suneel,

Altman, John,

Laine, Mika,

Piek, Jan J,

Nam, Chang-Wook,

Nijjer, Sukhjinder S,

Samady, Habib,

Walters, Darren,

Davies, Justin E,

Seto, Arnold H,

Patel, Manesh R,

Singh, Jasvindar,

Jeremias, Allen,

Koo, Bon-Kwon,

Tang, Kare,

Erglis, Andrejs,

Escaned, Javier,

Vinhas, Hugo,

Indolfi, Ciro,

Ribichini, Flavo,

Dehbi, Hakim-Moulay,

Di Mario, Carlo,

Hellig, Farrel,

Petraco, Ricardo,

Niccoli, Giampaolo,

Shin, Eun-Seok,

Takashima, Hiroaki,

Gerber, Robert T,

Malik, Iqbal S,

Bojara, Waldemar,

van Royen, Niels,

Khashaba, Ahmed,

Sezer, Murat,

Tanaka, Nobuhiro,

Baptista, Sérgio B,

Bhindi, Ravinay,

Sen, Sayan,

Brugaletta, Salvatore,

Kikuta, Yuetsu,

Alghamdi, Ali,

Alegria-Barrero, Eduardo,

Van Belle, Eric,

Janssens, Luc

2017

Overview

In this trial involving 2492 patients, coronary revascularization guided by iFR, as compared with fractional flow reserve-guided revascularization, was within the prespecified margin for noninferiority with respect to major adverse cardiac events. For the past 20 years, physiological measurements obtained during invasive procedures have been used to guide coronary revascularization. Pioneering work supported the use of flow measurements to make safe decisions about revascularization, 1 , 2 but this approach was soon superseded by the use of fractional flow reserve (FFR), which measures pressure as a surrogate of flow to estimate the severity of stenosis. 3 – 5 FFR was successful largely because of its technical simplicity and because clinical trials showed that it was associated with improved clinical outcomes after percutaneous coronary intervention (PCI). 6 , 7 Consequently, FFR is now included in the appropriate-use criteria for . . .

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Publisher

Massachusetts Medical Society

Subject

Acute Coronary Syndrome - diagnostic imaging

/ Acute Coronary Syndrome - physiopathology

/ Aged

/ Angina Pectoris - diagnostic imaging

/ Angina Pectoris - physiopathology

/ Angioplasty

/ Cardiology