Despite data to correlate use of fractional flow reserve (FFR) with improved long-term outcomes as well as reductions in both unnecessary stenting and healthcare utilization costs, FFR is underused in the evaluation and treatment of coronary artery disease (CAD).
At our facility, we advocate for appropriate use of FFR to assess the hemodynamic significance of angiographic lesions, especially for intermediate lesions, to determine whether to stent. Consensus guidelines recommend medical therapy for stable ischemic heart disease with an intermediate coronary stenosis (ICS) (40-70 percent diameter stenosis) of unclear significance when FFR is greater than 0.80 (Catheter Cardiovasc Interv 2014;83:509-18).