Picture perfect? Performance of quantitative coronary angiography-based vessel FFR versus pressure wire-based FFR

Measurement of fractional flow reserve (FFR) at the time of invasive coronary angiography is an established method for the assessment of epicardial coronary lesion severity. International guidelines recognise its role in guiding decisions on revascularisation12, specifically, an FFR >0.80 facilitates a safe deferral of coronary intervention3. The use of FFR alters clinician management plans in the catheterisation laboratory4, and more importantly, may lead to improved clinical outcomes in chronic and acute coronary syndromes56.

Despite these developments, FFR adoption remains limited in clinical practice, primarily due to the requirement for coronary instrumentation, increased procedural time and cost, and patient intolerance ...