Hemodynamic Assessment of Coronary Bifurcation Lesions:  FFR, iFR, CFR and FFR-CT

Dr. Haluk Furkan Şahan

Ankara Etlik City Hospital, Department of Cardiology, Ankara, Türkiye

ABSTRACT

Coronary artery disease (CAD) is a major factor in cardiovascular mortality and morbidity. Coronary bifurcation lesions (CBLs) pose significant challenges in interventional cardiology among the various forms of coronary artery lesions. Conventional angiography is often insufficient to assess the functioning importance of these lesions.

Several hemodynamic tools have been developed to evaluate coronary stenosis. Fractional Flow Reserve (FFR) is an invasive technique to assess how stenosis affects blood flow. Instantaneous Wave-Free Ratio (iFR) provides a non-hyperemic alternative, delivering comparable diagnostic accuracy without requiring pharma- cologic agents. Coronary Flow Reserve (CFR) examines the comprehensive functionality of coronary hemo- dynamics, making it especially valuable in cases of microvascular dysfunction or diffuse disease. Computed Tomography Fractional Flow Reserve (FFR-CT) combines anatomical imaging with computational fluid dynamics, providing a non-invasive alternative to traditional FFR.

These methods provide valuable insights for evaluating CBLs and help optimize treatment strategies, ulti- mately improving patient outcomes.

Keywords: Coronary circulation; Coronary stenosis; Percutaneous coronary intervention; FFR; iFR; CFR; FFR-CT

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