Interventional cardiologists usually administer a technique known as Fractional flow reserve (FFR) in order to measure pressure differences across blocks present inside the blood vessel which supply blood to the heart muscle. Cardiologists conduct the technique to discover if that particular block decreases blood supply or not.
FFR can be defined by the maximal flow through the vessel when there is a block, compared to the maximal flow in the blood vessel if it were normal. When a cardiologist conducts the procedure of FFR, he moves a pressure sensitive wire into the arteries which are quite close to the heart. With this wire, the cardiologist evaluates the flow of blood, and its pressure. Ultimately, the cardiologist records two measurements of this pressure: one “above” the block, and second “below” it.
In detail, the procedure of FFR can be described as an invasive test conducted through the use of a guidewire. A special small sensor is attached to the tip guidewire which can evaluate the pressure and the flow across the block. The guidewire is moved into the heart blood vessel, supervised by x-ray guidance in the cath lab, across the block. The maximal blood flow is prompted by inoculating medicines such as adenosive. The pressure, before and after the block, is calculated and FFR result is recorded by a software after calculations.
Many scientific studies have authenticated FFR and most importantly, it is used to measure the seriousness of a block inside the blood vessel. So it can be conferred that FFR aids in assessing and finding out if a block inside the blood vessels is a potential threat. Moreover, the procedure finds out if the block requires treatment with stent or surgery or if it can be simply treated with medicines.
The procedure predominantly identifies blocks which are possibly serious and may lead to a heart attack later and hence requires intervention.
In addition, through the use of FFR test, a patient may know his heart condition and can avoid unwarranted stent or surgery. With the implementation of FFR, a potentially dangerous block can be readily identified.
The timing of conducting an FFR is usually after the administration of a coronary angiogram. After the coronary angiogram results have identified blocks inside the blood vessel, FFR is implemented only if the blocks seem borderline by visual appearance in order to confirm the need of stenting. Furthermore, FFR is not usually conducted when the blocks appear very tight as recorded by angiogram.
According to multiple clinical trials, value 0.8 has been recognized as the cut off FFR value. A value of above 0.8 infers that that the block can be treated with simple medications and stent or bypass surgery is unrequired. TheFFR guidewire is also utilized for performing PCI/stenting if the value is less than 0.8.
There are many scientific studies such as “DEFER STUDY,” “FAME STUDY,” which have validated thatFFR is a beneficial procedure that can be used for making an accurate judgment by the cardiologist in the cath lab. A “FIND STUDY” has revealed that FFR lowers the cost by circumventing needless stenting in Indian patients .
I really wonder why a beneficial technology like FFR, which has got conclusive evidence from around the world, has not spread to other hospitals. According to my opinion it is a 5-minute test and provides amazing results.
Currently, FFR has become a routine part of examination at Apollo. Most significantly, the patients believe in the doctors’ skill and judgment, and are aware that the doctors are always thinking of their well-being.