FFR post-PCI: what we learned from the FFR-SEARCH study

Abstract

WHAT DO WE KNOW ABOUT FRACTIONAL FLOW RESERVE AFTER STENTING? The introduction of the concept of fractional flow reserve (FFR) in the mid 90s moved coronary physiology from experimental science to routine use at the cath lab.1-3 Added to the better understanding of basic physiological mechanisms such as self-regulation and compensatory vasodilation and the coronary flow reserve introduced 20 years earlier by Gould et al.,4 FFR has undeniably changed our interpretation of coronary angiograms and had a major influence on the clinical decision-making process, and patient outcomes.3,5,6 This has resulted in the unique adoption of FFR as the only physiological index with a class I A indication for use in the clinical practice guidelines produced by the most important cardiologic societies worldwide.7,8 FFR has taught us that coronary angiography and the anatomic images we can acquire at the cath lab only provide moderately reliable measures of the functional significance of coronary artery disease and myocardial ischemia. Also, there is undeniable proof that the decision-making process based on functional measurements leads to better outcomes compared to angiography alone.3,5,6 In contrast, the interpretation of FFR after coronary intervention is still ambiguous. Basically, we should be aware that the status of a coronary artery immediately after...

Keywords

• TAVI
• Anticoagulation
• Apixaban
• Vitamin K antagonist