title: [Fractional flow reserve and instantaneous wave-free ratio for the physiological assessment of coronary artery stenosis in the catheterization laboratory: Practical tips].
abstract: In recent years, a large body of evidence has revealed the limitations of angiographic evaluation in determining the physiological significance of coronary stenosis, particularly when these are intermediate lesions. Percutaneous coronary interventions (PCI) guided by physiological assessment using fractional flow reserve (FFR) have been shown to reduce cardiovascular events when compared to angiography alone. Recently, another coronary physiologic parameter has been introduced: the "instantaneous wave-free ratio" (iFR). In this review, we will discuss the FFR, the iFR, and their use in the functional assessment of coronary stenosis in the cardiac catheterization laboratory. This review will cover theoretical aspects for non-interventional cardiologists, as well as practice points and common pitfalls related to coronary physiological assessment for interventional cardiologists.
authors.affiliation: Interventional Cardiology Division, Department of Medicine, Montreal Heart Institute, université de Montréal, Montréal, QC, Canada.
authors.forename: F
authors.initials: F
authors.lastname: Picard
authors.affiliation: Interventional Cardiology Division, Department of Medicine, Montreal Heart Institute, université de Montréal, Montréal, QC, Canada.
authors.forename: V X
authors.initials: VX
authors.lastname: Tadros
authors.affiliation: Interventional Cardiology Division, Department of Medicine, Montreal Heart Institute, université de Montréal, Montréal, QC, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Pighi
authors.affiliation: Interventional Cardiology Division, Department of Medicine, Montreal Heart Institute, université de Montréal, Montréal, QC, Canada.
authors.forename: V
authors.initials: V
authors.lastname: Spagnoli
authors.affiliation: Interventional Cardiology Division, Department of Medicine, Montreal Heart Institute, université de Montréal, Montréal, QC, Canada.
authors.forename: Q
authors.initials: Q
authors.lastname: De Hemptinne
authors.affiliation: Interventional Cardiology Division, Department of Medicine, Montreal Heart Institute, université de Montréal, Montréal, QC, Canada. Electronic address: qh.ly@umontreal.ca.
authors.forename: H Q
authors.initials: HQ
authors.lastname: Ly
mesh_terms: D006328:Cardiac Catheterization; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology; D023921:Coronary Stenosis / Q000503:physiopathology* / Q000628:therapy; D053805:Fractional Flow Reserve, Myocardial / Q000502:physiology*; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D009204:Myocardial Revascularization
keywords: Athérosclérose; Coronary artery disease; FFR; Fractional flow reserve; Functional assessment; Guide de pression; Instantaneous wave-free ratio; Ischémie myocardique; Myocardial ischemia; Pressure wire; iFR; Évaluation coronaire fonctionnelle