Impact of pressure guidewire on model-based FFR prediction

46/2022

Impact of pressure guidewire on model-based FFR prediction

Wednesday 13th July 2022

Lucca, A.; Fraccarollo, L.; Fossan, F.E.; Braten, A.T.; Pozzi, S.; Vergara, C.; Muller, L.O.

Fractional Flow Reserve (FFR) is used to characterize the functional significance of coronary artery stenoses. FFR is assessed under hyperemic conditions by invasive measurements of trans-stenotic pressure thanks to the insertion of a pressure guidewire across the coronary stenosis during catheterization. In order to overcome the potential risk related to the invasive procedure and to reduce the associated high costs, blood flow simulations that incorporate clinical imaging and patient-specific characteristics have been proposed. Most CCTA-derived FFR models neglect the potential influence of the guidewire on the flow and pressure. We aim to quantify the impact of taking into account the presence of the guidewire in model-based FFR prediction. We adopt a CCTA-derived FFR model and perform simulations with and without the guidewire for 18 patients with suspected stable CAD. Presented results show that the presence of the guidewire leads to a tendency to predict a lower FFR value. The FFR reduction is prominent in cases of severe stenoses, while the influence of the guidewire is less pronounced in cases of moderate stenoses. Particular attention should be drawn to intermediate stenoses, in which the presence of the guidewire can change the diagnostic outcome and consequently the clinical decision.