Is Quantitative Flow Ratio Guidance the Future of PCI?

A randomized study demonstrated better clinical outcomes compared with standard angiographic guidance.

Assessment of fractional flow reserve with pressure wire–based physiologic guidance of percutaneous coronary intervention (PCI) improves clinical outcomes compared with standard angiography guidance. However, this technique is underutilized in practice, and many PCI decisions are based on the angiographic appearance of lesions. The quantitative flow ratio (QFR) is a new technique that can assess the hemodynamic significance of coronary stenoses based on angiography alone without a wire or need for pharmacologic hyperemia. In this randomized trial, Chinese investigators compared clinical outcomes of PCI with QFR guidance versus standard angiographic assessment (NCT03656848).

Some 3800 patients with at least one 50%-to-90%-diameter stenosis ba…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)