Mini-Focus Issue: Optical Coherence Tomography
State-of-the-Art Paper
Functional Measurement of Coronary Stenosis

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Fractional flow reserve (FFR) is considered nowadays as the gold standard for invasive assessment of physiologic stenosis significance and an indispensable tool for decision making in coronary revascularization. Use of FFR in the catheterization laboratory accurately identifies which lesions should be stented and improves the outcome in most elective clinical and angiographic conditions. Recently, FFR has been upgraded to a class IA classification in multivessel percutaneous coronary intervention in the guidelines on coronary revascularization of the European Society of Cardiology. In this state-of-the-art paper, the basic concept of FFR and its application, characteristics, and use in several subsets of patients are discussed from a practical point of view.

Key Words

fractional flow reserve
myocardial ischemia
percutaneous coronary intervention
revascularization

Abbreviations and Acronyms

FFR
fractional flow reserve
LAD
left anterior descending coronary artery
LCx
left circumflex coronary artery
MI
myocardial infarction
Pa
mean aortic pressure as measured by the guiding catheter
PCI
percutaneous coronary intervention
Pd
distal coronary pressure, measured by the pressure wire

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Dr. Pijls has received institutional research grants from St. Jude Medical, Abbott, and Maquet; and is a consultant for St. Jude Medical. Dr. Sels has reported that he has no relationships relevant to the contents of this paper to disclose.