Computerised Methodologies for Non-Invasive Angiography-Derived Fractional Flow Reserve Assessment: A Critical Review

Autor: Anantharaman Ramasamy, Chongying Jin, Vincenzo Tufaro, Retesh Bajaj, Yakup Kilic, Hannah Safi, Rajiv Amersey, Daniel Jones, Ryo Torii, Alexandra Lansky, Anthony Mathur, Christos V. Bourantas, Andreas Baumbach
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Journal of Interventional Cardiology, Vol 2020 (2020)
Druh dokumentu: article
ISSN: 0896-4327
1540-8183
DOI: 10.1155/2020/6381637
Popis: Fractional flow reserve is the gold standard for assessing the haemodynamic significance of intermediate coronary artery stenoses. Cumulative evidence has shown that FFR-guided revascularisation reduces stent implantations and improves patient outcomes. However, despite the wealth of evidence and guideline recommendations, its use in clinical practice remains minimal. Patient and technical limitations of FFR as well as the need for intracoronary instrumentation, use of adenosine, and increased costs have limited FFR’s applicability in clinical practice. Over the last decade, several angiography-derived FFR software packages have been developed which do not require intracoronary pressure assessment with a guidewire or need for administration of hyperaemic agents. At present, there are 3 commercially available software packages and several other non-commercial technologies that have been described in the literature. These technologies have been validated against invasive FFR showing good accuracy and correlation. However, the methodology behind these solutions is different—some algorithms are based on solving the governing equations of fluid dynamics such as the Navier–Stokes equation while others have opted for a more simplified mathematical formula approach. The aim of this review is to critically appraise the methodology behind all the known angiography-derived FFR technologies highlighting the key differences and limitations.
Databáze: Directory of Open Access Journals
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