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Percutaneous coronary intervention fractional flow reserve

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

2011 and 2005 ACCF/AHA/SCAI Guidelines for Percutaneous Coronary Intervention (DO NOT EDIT)[1][2]

Fractional Flow Reserve (DO NOT EDIT)[1]

Class IIa
“1. Fractional flow reserve is reasonable to assess angiographic intermediate coronary lesions (50% to 70% diameter stenosis) and can be useful for guiding revascularization decisions in patients with Sudden ischemic heart disease (SIHD).[3][4][5][6][7] (Level of Evidence: A)”

Coronary Artery Pressure and Flow:Use of Fractional Flow Reserve and Coronary Vasodilatory Reserve (DO NOT EDIT)[2]

Class III
“1.Routine assessment with intracoronary physiologic measurements such as Doppler ultrasound or fractional flow reserve to assess the severity of angiographic disease in patients with a positive, unequivocal noninvasive functional study is not recommended.(Level of Evidence: C) ”
Class IIa
“1.It is reasonable to use intracoronary physiologic measurements (Doppler ultrasound, fractional flow reserve) in the assessment of the effects of intermediate coronary stenoses (30% to 70% luminal narrowing) in patients with anginal symptoms. Coronary pressure or Dopplervelocimetry may also be useful as an alternative to performing noninvasive functional testing (e.g., when the functional study is absent or ambiguous) to determine whether an intervention is warranted.(Level of Evidence: B) ”
Class IIb
“1.Intracoronary physiologic measurements may be considered for the evaluation of the success of PCI in restoring flow reserve and to predict the risk of restenosis. (Level of Evidence: C) ”
“2. Intracoronary physiologic measurements may be considered for the evaluation of patients with anginal symptoms without an apparent angiographic culprit lesion. (Level of Evidence: C) ”

References

  1. ↑ 1.0 1.1 Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH (2011). “2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions” (PDF). Journal of the American College of Cardiology. 58 (24): 2550–83. doi:10.1016/j.jacc.2011.08.006. PMID 22070837. Retrieved 2011-12-08. Text “PDF” ignored (help); Unknown parameter |month= ignored (help)
  2. ↑ 2.0 2.1 Smith SC, Feldman TE, Hirshfeld JW, Jacobs AK, Kern MJ, King SB; et al. (2006). “ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update 2001 Guidelines for Percutaneous Coronary Intervention)”. Circulation. 113 (7): e166–286. doi:10.1161/CIRCULATIONAHA.106.173220. PMID 16490830.
  3. ↑ Tonino PA, De Bruyne B, Pijls NH, Siebert U, Ikeno F, van’ t Veer M, Klauss V, Manoharan G, Engstrøm T, Oldroyd KG, Ver Lee PN, MacCarthy PA, Fearon WF (2009). “Fractional flow reserve versus angiography for guiding percutaneous coronary intervention”. The New England Journal of Medicine. 360 (3): 213–24. doi:10.1056/NEJMoa0807611. PMID 19144937. Retrieved 2011-12-09. Unknown parameter |month= ignored (help)
  4. ↑ Hamilos M, Muller O, Cuisset T, Ntalianis A, Chlouverakis G, Sarno G, Nelis O, Bartunek J, Vanderheyden M, Wyffels E, Barbato E, Heyndrickx GR, Wijns W, De Bruyne B (2009). “Long-term clinical outcome after fractional flow reserve-guided treatment in patients with angiographically equivocal left main coronary artery stenosis”. Circulation. 120 (15): 1505–12. doi:10.1161/CIRCULATIONAHA.109.850073. PMID 19786633. Retrieved 2011-12-09. Unknown parameter |month= ignored (help)
  5. ↑ Pijls NH, van Schaardenburgh P, Manoharan G, Boersma E, Bech JW, van’t Veer M, Bär F, Hoorntje J, Koolen J, Wijns W, de Bruyne B (2007). “Percutaneous coronary intervention of functionally nonsignificant stenosis: 5-year follow-up of the DEFER Study”. Journal of the American College of Cardiology. 49 (21): 2105–11. doi:10.1016/j.jacc.2007.01.087. PMID 17531660. Retrieved 2011-12-09. Unknown parameter |month= ignored (help)
  6. ↑ Pijls NH, Fearon WF, Tonino PA, Siebert U, Ikeno F, Bornschein B, van’t Veer M, Klauss V, Manoharan G, Engstrøm T, Oldroyd KG, Ver Lee PN, MacCarthy PA, De Bruyne B (2010). “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”. Journal of the American College of Cardiology. 56 (3): 177–84. doi:10.1016/j.jacc.2010.04.012. PMID 20537493. Retrieved 2011-12-09. Unknown parameter |month= ignored (help)
  7. ↑ Tonino PA, Fearon WF, De Bruyne B, Oldroyd KG, Leesar MA, Ver Lee PN, Maccarthy PA, Van’t Veer M, Pijls NH (2010). “Angiographic versus functional severity of coronary artery stenoses in the FAME study fractional flow reserve versus angiography in multivessel evaluation”. Journal of the American College of Cardiology. 55 (25): 2816–21. doi:10.1016/j.jacc.2009.11.096. PMID 20579537. Retrieved 2011-12-09. Unknown parameter |month= ignored (help)

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