Heart Centre, John Radcliffe Hospital, Oxford University Hospitals, NHS Foundation Trust, Oxford, United Kingdom (G.L.D.M., R.S., A.P.B.).
MedStar Washington Hospital Centre, Interventional Cardiology Department, Washington, DC (Y.O., H.M.G.-G., A.H.-K., E.S., K.D., R.W.).
Circ Cardiovasc Interv. 2020 Apr;13(4):e008487. doi: 10.1161/CIRCINTERVENTIONS.119.008487. Epub 2020 Apr 16.
Fractional flow reserve is the current invasive gold standard for assessing the ischemic potential of an angiographically intermediate coronary stenosis. Procedural cost and time, the need for coronary vessel instrumentation, and the need to administer adenosine to achieve maximal hyperemia remain integral components of invasive fractional flow reserve. The number of new alternatives to fractional flow reserve has proliferated over the last ten years using techniques ranging from alternative pressure wire metrics to anatomic simulation via angiography or intravascular imaging. This review article provides a critical description of the currently available or under-development alternatives to fractional flow reserve with a special focus on the available evidence, pros, and cons for each with a view towards their clinical application in the near future for the functional assessment of coronary artery disease.
分流量储备是目前评估血管造影中间度冠状动脉狭窄缺血潜力的有创金标准。有创分流量储备的程序成本和时间、对冠状动脉血管仪器的需求以及给予腺苷以达到最大充血的需求仍然是其不可或缺的组成部分。在过去十年中，使用从替代压力导丝指标到通过血管造影或血管内成像进行解剖模拟的技术，有创分流量储备的新替代方法的数量不断增加。本文批判性地描述了目前可用或正在开发的分流量储备替代方法，特别关注每种方法的现有证据、优缺点，以期在不久的将来将其用于冠状动脉疾病的功能评估。
