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Practical Guide to FFR

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Dr A Sreenivas Kumar, Hyderabad    05 March 2019

  • Standardized approach to FFR: Indication, prepare your device, position the wire, induce hyperemia, measure gradient, store the tracing, interpret the tracing ...Be consistent.
  • FFR would be higher with microvascular disease than it would be without microvascular disease. But, it still indicates exactly to what degree maximum blood flow can be improved by stenting an epicardial coronary stenosis!
  • The hyperemic pull-back recording is the best practical way to guide where exactly the stent(s) should be placed and to evaluate the result.
  • FFR pitfalls: Height of the fluid-filled transducer, equalization, hyperemia, drift, guiding catheter, side holes, whipping, position of the cursor, accordion effect.

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