FFR (Fractional Flow Reserve)
Coronary angiography is a two dimensional visualization (anatomical assessment) of the coronary artery (blood vessels in the heart) by injecting dye inside the heart. The percentage of narrowing or blockage (stenosis) is estimated by direct visualization. When the stenosis is severe (>70%) or mild (<50%) – this estimate will work fine. However, there are situations where the stenosis in the coronary artery is borderline (around 50-70%). During these times, it becomes very difficult to accurately assess the blood flow in that segment to decide on further management (medical therapy/angioplasty with stent/or CABG). FFR is a technique to directly assess the blood flow in coronary artery using a special wire inserted into the coronary artery, which gives us a real estimate of the stenosis to help in decision-making. This is particularly very useful in situations mentioned above. The procedure is similar to angiogram to start with, but uses a special wire, which needs to be inserted in the artery to be tested. This wire will be able to measure the pressure and blood flow inside the blood vessel and thus inform us if there is any compromise in the blood flow.