Image Question-2

A 51 year male patient came with complain of chest pain on exertion. Patient taken for angiogram found to have two vessel LAD and LCX

The following test is done for

[A] Critical Stenosis of LCX
[B] Significant Proximal RCA Disease
[C] Angiographically intermediate LCX lesion
[D] Myocardial bridging of Proximal LCX

Fractional flow reserve (FFR) measurement NOT intended to be done in case of

[A] Identify the precise location of a coronary lesion
[B] Identify appropriate culprit lesion in multivessel coronary artery disease
[C] Angiographically intermediate LCX lesion
[D] Chronic total occlusion

  • Fractional flow reserve (FFR) measurement involves determining the ratio between the maximum achievable blood flow in a diseased coronary artery and the theoretical maximum flow in a normal coronary artery.
  • An FFR of 1.0 is widely accepted as normal.
  • An FFR lower than 0.75-0.80 is generally considered to be associated with myocardial ischemia (MI)
  • It provides a quantitative assessment of the functional severity of a coronary artery stenosis identified during coronary angiography and cardiac catheterization.

Indications

Indications for FFR measurement are as follows:

  1. To determine the physiologic and hemodynamic significance of an angiographically intermediate coronary stenosis
  2. To identify appropriate culprit lesion(s) in multivessel coronary artery disease (CAD)
  3. To measure the functional importance of stenosis in the presence of distal collateral flow
  4. To identify the precise location of a coronary lesion when the angiographic image is unclear

Note that this procedure is not intended for use in the setting of a total vessel occlusion.

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