Fractional Flow Reserve (FFR) measurement involves determining the ratio between the maximum achievable blood flow in the presence of stenosis compared to the theoretical maximum flow in a normal coronary artery with a hypothetical absence of the stenosis.
Fractional Flow Reserve measurement
FFR is easily measured during routine coronary angiography by using a pressure wire to calculate the ratio between coronary pressure distal to a coronary artery stenosis and aortic pressure under conditions of maximum myocardial hyperemia.1 This ratio represents the potential decrease in coronary flow distal to the coronary stenosis.
Various clinical studies demonstrate that physiologic lesion assessment by FFR to guide routine PCI is superior5 to current angiography guided treatment.
Identify appropriate culprit lesion(s) in multi-vessel coronary artery disease (CAD)
Clinically proven for ischemia detection 3,6
Supported by guidelines worldwide 3, 7
Determine the physiologic and hemodynamic significance of an stenosis 2
Measure the functional importance of a stenosis in the presence of distal collateral flow 2
Identify the precise location of a coronary lesion when the angiographic image is unclear 2
FFR ischemia scale
An FFR lower than 0.75-0.80 is generally considered to be associated with myocardial ischemia.3
FFR < 0.75 was validated against the 3 gold standard tests to correlate with ischemia with 100% specificity
FFR between 0.75 and 0.80 may indicate ischemia
FFR > 0.80 is highly likely to be non‑ischemic
AUC guidelines reflect the FAME cutoff of 0.80
FFR-guided procedures improved outcomes over angio-guided procedures3 1-year outcomes.
†Relative risk reduction
The FFR group performed significantly better in MACE-free survival 30 – 360 days
The FFR group was statistically significant in Death/MI and MACE but improved in all metrics vs. the angio-guided group
FAME II demonstrated that PCI was superior to medical therapy with FFR > 0.84 death, MI, and revascularization.
FAME II randomized patients with FFR < 0.8 to PCI + MT† or MT compared to patients with FFR > 0.8 who received MT
83% relative risk reduction in urgent revascularization in FFR PCI + MT group
The Verrata Pressure Guide Wire
One wire, one system, multi-modality
Compatible with Philips Volcano consoles
iFR and FFR modalities are on adjacent tabs in an upgraded Volcano console
Switch back and forth between modalities easily, and effortlessly
Pijls NH, Fearon WF, Tonino PA, et al. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention in patients with multivessel coronary artery disease: 2-year follow-up of the FAME (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) study. J Am Coll Cardiol. 2010;56(3):177-84
De Bruyne B, Pijls NH, Kalesan B, et al. Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease. N Engl J Med. 2012;367(11):991-1001.
Physiologic Assessment of Coronary Artery Disease: Focus on Fractional Flow Reserve. Korean J Radiol. 2016 May-Jun; 17(3): 307–320.
Cardiac CT for myocardial ischaemia detection and characterization—comparative analysis. Br J Radiol. November 2014; 87(1043): 20140159.
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