Fractional flow reserve(FFR) is an Intra coronary hemodynamic parameter promoted recently to assess the physiological impact of a coronary lesion . Though it sounds logically attractive the concept is sailing in rough seas .I am afraid FFR is drowning a fairly useful tool of IVUS along with it !
Read this large study on FFR (JAMA June 2014) .It seems to suggest FFR is a costly and unnecessary accessory in cath lab
Critical thoughts on FFR
It adds time , money , and procedural risk* to any given patient .The only possible use is to reduce the proliferating stent usage !But the irony is complete as we do our daily business in modern cath suits .To negate one indulgence we need to need to indulge in another ! (Junk begets Junk !)
It reflects lack of courage on the part of cardiologists to advice medical management even in obvious low risk lesions !
It is unfortunate ,we need a scientific or a pseudo scientific tool to lift up our sagging medical intellect !
* crossing delicate and often complex lesions without any major purpose is bad wisdom !
Related article in this site FFR- Futile flow reserve ?
Dr.S.Venkatesan MD 
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