Cardiovascular Institute, San Carlos Clinical University Hospital, Madrid, Spain.
Minerva Med. 2011 Oct;102(5):399-415.
Fractional flow reserve (FFR), an invasive pressure-derived index of stenosis severity, can be performed easily, rapidly, and safely in patients with coronary artery disease as a surrogate of non-invasive detection of ischemia. Over the last decades, profound clinical and scientific evaluation has demonstrated that FFR is one of the few diagnostic modalities that improve patient outcome and, at the same time, are cost-effective and cost-saving. The increasing use of PCI to treat multivessel disease and complex anatomical subsets has created new demands for accurate, "per stenosis" assessment, since revascularisation should be performed only in those stenosis that are ischaemia generating. Recent studies have demonstrated that this attitude results in better patient outcomes. Altogether, current evidence clearly supports the measurement of FFR in catheterization laboratories in order to provide objective and complementary data to coronary angiography. The purpose of this review is to discuss the value of FFR in the diagnosis and treatment of patients with different anatomical subsets, including intermediate stenosis, multivessel disease, left main disease, serial stenosis, ostial and bifurcation lesions, saphenous vein graft disease and in-stent restenosis, as well as in those presenting with acute coronary syndromes.
分流量比值（FFR），一种通过侵入性压力检测狭窄严重程度的指标，可以作为缺血无创检测的替代方法，方便、快速、安全地应用于冠心病患者。在过去的几十年中，深入的临床和科学评估已经证明，FFR 是为数不多的能够改善患者预后的诊断方法之一，同时具有成本效益和节省成本的优势。经皮冠状动脉介入治疗（PCI）用于治疗多支血管病变和复杂解剖亚组的应用日益增多，这对准确的“单支血管狭窄”评估提出了新的要求，因为只有在导致缺血的狭窄病变中才需要进行血运重建。最近的研究表明，这种态度可以带来更好的患者预后。总的来说，目前的证据清楚地支持在导管室测量 FFR，以提供与冠状动脉造影互补的客观数据。本文旨在讨论 FFR 在不同解剖亚组患者的诊断和治疗中的价值，包括中度狭窄、多支血管病变、左主干病变、串联狭窄、开口和分叉病变、大隐静脉桥病变和支架内再狭窄，以及急性冠状动脉综合征患者中的应用。
