Technical aspects and limitations of fractional flow reserve measurement

Abstract

Background: The only indication for coronary revascularization is elimination of ischaemia. Invasive hemodynamic methods (fractional flow reserve – FFR and instantaneous wave-free ratio (iFR) are superior to coronary angiography in detection of lesions causing myocardial ischaemia. Current European guidelines for myocardial revascularization recommend using of FFR for detection of functional assessment of lesions severity in category IA and number of these procedures increases. However, routine usage of these methods requires knowledge of technical requirements and limitations.

Aim: The aim of the study is to summarise good clinical practice for FFR and iFR measurements with explanation of possible technical challenges, that are necessary for increasing of measurement accuracy.

Conclusions: Authors describe frequent technical mistakes and malpractice during invasive assessment of lesion severity in coronary arteries.

Keywords:

• Fractional flow reserve
• instantaneous wave-free ratio
• coronary artery disease

Disclosure statement

The authors have nothing to disclose.

Additional information

Funding

This study was supported, in part, by a grant from the Czech Health Research Council of the Czech Republic, AZV 16-28525A, and by the Charles University in Prague grant, project GA UK No. 191415.