Computerised Methodologies for Non-Invasive Angiography-Derived Fractional Flow Reserve Assessment: A Critical Review

Fractional flow reserve is the gold standard for assessing the haemodynamic significance of intermediate coronary artery stenoses. Cumulative evidence has shown that FFR-guided revascularisation reduces stent implantations and improves patient outcomes. However, despite the wealth of evidence and gu...

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Main Authors: Anantharaman Ramasamy, Chongying Jin, Vincenzo Tufaro, Retesh Bajaj, Yakup Kilic, Hannah Safi, Rajiv Amersey, Daniel Jones, Ryo Torii, Alexandra Lansky, Anthony Mathur, Christos V. Bourantas, Andreas Baumbach
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Journal of Interventional Cardiology
Online Access:http://dx.doi.org/10.1155/2020/6381637
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author Anantharaman Ramasamy
Chongying Jin
Vincenzo Tufaro
Retesh Bajaj
Yakup Kilic
Hannah Safi
Rajiv Amersey
Daniel Jones
Ryo Torii
Alexandra Lansky
Anthony Mathur
Christos V. Bourantas
Andreas Baumbach
author_facet Anantharaman Ramasamy
Chongying Jin
Vincenzo Tufaro
Retesh Bajaj
Yakup Kilic
Hannah Safi
Rajiv Amersey
Daniel Jones
Ryo Torii
Alexandra Lansky
Anthony Mathur
Christos V. Bourantas
Andreas Baumbach
author_sort Anantharaman Ramasamy
collection DOAJ
description Fractional flow reserve is the gold standard for assessing the haemodynamic significance of intermediate coronary artery stenoses. Cumulative evidence has shown that FFR-guided revascularisation reduces stent implantations and improves patient outcomes. However, despite the wealth of evidence and guideline recommendations, its use in clinical practice remains minimal. Patient and technical limitations of FFR as well as the need for intracoronary instrumentation, use of adenosine, and increased costs have limited FFR’s applicability in clinical practice. Over the last decade, several angiography-derived FFR software packages have been developed which do not require intracoronary pressure assessment with a guidewire or need for administration of hyperaemic agents. At present, there are 3 commercially available software packages and several other non-commercial technologies that have been described in the literature. These technologies have been validated against invasive FFR showing good accuracy and correlation. However, the methodology behind these solutions is different—some algorithms are based on solving the governing equations of fluid dynamics such as the Navier–Stokes equation while others have opted for a more simplified mathematical formula approach. The aim of this review is to critically appraise the methodology behind all the known angiography-derived FFR technologies highlighting the key differences and limitations.
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spelling doaj-art-02c2b83ae2fc4a859a9332e0edd50eae2025-08-20T03:54:15ZengWileyJournal of Interventional Cardiology0896-43271540-81832020-01-01202010.1155/2020/63816376381637Computerised Methodologies for Non-Invasive Angiography-Derived Fractional Flow Reserve Assessment: A Critical ReviewAnantharaman Ramasamy0Chongying Jin1Vincenzo Tufaro2Retesh Bajaj3Yakup Kilic4Hannah Safi5Rajiv Amersey6Daniel Jones7Ryo Torii8Alexandra Lansky9Anthony Mathur10Christos V. Bourantas11Andreas Baumbach12Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UKDepartment of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UKDepartment of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UKDepartment of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UKDepartment of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UKDepartment of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UKDepartment of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UKDepartment of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UKDepartment of Mechanical Engineering, University College London, London, UKDepartment of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UKDepartment of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UKDepartment of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UKDepartment of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UKFractional flow reserve is the gold standard for assessing the haemodynamic significance of intermediate coronary artery stenoses. Cumulative evidence has shown that FFR-guided revascularisation reduces stent implantations and improves patient outcomes. However, despite the wealth of evidence and guideline recommendations, its use in clinical practice remains minimal. Patient and technical limitations of FFR as well as the need for intracoronary instrumentation, use of adenosine, and increased costs have limited FFR’s applicability in clinical practice. Over the last decade, several angiography-derived FFR software packages have been developed which do not require intracoronary pressure assessment with a guidewire or need for administration of hyperaemic agents. At present, there are 3 commercially available software packages and several other non-commercial technologies that have been described in the literature. These technologies have been validated against invasive FFR showing good accuracy and correlation. However, the methodology behind these solutions is different—some algorithms are based on solving the governing equations of fluid dynamics such as the Navier–Stokes equation while others have opted for a more simplified mathematical formula approach. The aim of this review is to critically appraise the methodology behind all the known angiography-derived FFR technologies highlighting the key differences and limitations.http://dx.doi.org/10.1155/2020/6381637
spellingShingle Anantharaman Ramasamy
Chongying Jin
Vincenzo Tufaro
Retesh Bajaj
Yakup Kilic
Hannah Safi
Rajiv Amersey
Daniel Jones
Ryo Torii
Alexandra Lansky
Anthony Mathur
Christos V. Bourantas
Andreas Baumbach
Computerised Methodologies for Non-Invasive Angiography-Derived Fractional Flow Reserve Assessment: A Critical Review
Journal of Interventional Cardiology
title Computerised Methodologies for Non-Invasive Angiography-Derived Fractional Flow Reserve Assessment: A Critical Review
title_full Computerised Methodologies for Non-Invasive Angiography-Derived Fractional Flow Reserve Assessment: A Critical Review
title_fullStr Computerised Methodologies for Non-Invasive Angiography-Derived Fractional Flow Reserve Assessment: A Critical Review
title_full_unstemmed Computerised Methodologies for Non-Invasive Angiography-Derived Fractional Flow Reserve Assessment: A Critical Review
title_short Computerised Methodologies for Non-Invasive Angiography-Derived Fractional Flow Reserve Assessment: A Critical Review
title_sort computerised methodologies for non invasive angiography derived fractional flow reserve assessment a critical review
url http://dx.doi.org/10.1155/2020/6381637
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