Noninvasive Fractional Flow Reserve Derived From Computed Tomography Angiography for Coronary Lesions of Intermediate Stenosis Severity

Abstract

Editorial see p 853 Clinical Perspective on p 889Fractional flow reserve (FFR) is a lesion-specific technique to determine the functional importance of a coronary stenosis. [8][9][10][11][12] FFR is often used for determination of the physiological significance of coronary lesions of intermediate

The Influences of Swirl Flow on Fractional Flow Reserve in Mild/Moderate/Severe Stenotic Coronary Arterial Models

“…The effect of stenosis is dominant in moderate/severe stenosis. These findings suggest that computed tomography (CT)-FFR values in previous computational studies that neglected the influence of swirl flow from the aortic valve may be slightly overestimated in the case of mild stenosis [37][38][39][40][41][42][43][44][45][46]. This overestimation of CT-FFR value may result in slightly lower sensitivity.…”

Fractional Flow Reserve and Coronary Computed Tomographic Angiography

“…A subgroup analysis restricted to 150 vessels in 82 patients with intermediate stenoses of 30% to 69% revealed improved sensitivity (34%-72%) and NPV (78%-90%) compared with CTA. 33 There was no improvement in specificity (72%-67%) and the PPV, while improved, (27%-41%) was unacceptably low. The study did not achieve its prespecified primary outcome goal for the level of perpatient diagnostic accuracy of >70% of the lower bound of the 95% confidence interval.…”

Anatomy and physiology in coronary artery disease imaging

“…As for TAG, one of the main parameters is attenuation through the coronary artery associated with morphology of the vessel lumen and other parameters. This proprietary method has been demonstrated to be somehow effective in providing the information about flow-limiting stenosis, [18][19][20] even though there are few studies and there is little information about the actual correspondence between FFRct-driven revascularization and outcomes, or medium/long-term longitudinal outcome studies.…”