Fractional Flow Reserve Computed Tomography ” FFR CT”
Vcathlab FFR-CT allows for a detailed anatomical and functional evaluation of coronary arteries. FFR CT is a newer imaging post-processing technique applied to coronary CTA data and uses computational fluid dynamics (CFD) according to the Navier-Stokes equations to generate an FFRCT mesh of the coronary tree. This involves creation of an anatomic 3D model of the entire coronary arterial system according to semiautomatic segmentation of the volumetric CTA data, as well as a physiologic model according to patient-specific inflow and outflow boundary condition assumptions, thereby theoretically mimicking the conditions of invasive FFR. Analogous to conventional FFR,0 this technique allows estimation of the physiologic impact of a stenosis at maximum hyperemia, with the same threshold value of 0.80 or less. Because of the mathematic complexity and computational power required for such an approach, this technique is currently applied off-site at a core laboratory. Additional techniques using machine learning have been described for computing FFRCT that reduce the time and computational power required for calculation. CFD method is currently the only method approved for patient use by the U.S. Food and Drug Administration (FDA), and current research showing the efficacy of FFRCT has primarily been performed using this method.
The FFR CT System consistently demonstrates excellent diagnostic performance compared to traditional invasive FFR wires across a wide spectrum of patients and lesion subgroups.
This pathway offers the highest diagnostic performance accuracy available from a non-invasive test to help identify ischemia. This path leads to targeted treatment plans and a better patient experience. (Detection accuracy = 95 percent)
Clinicians can use computational analysis for any clinically symptomatic patient in a stable condition with suspected stenosis. This route requires access to a computing center that provides analysis of hemodynamic parameters such as FFR CT along with the CT angiography center. You can introduce your patient to the computing center navigator for the computed CTA process to accompany your patient from time reservation to analysis.
After the patient contacts the navigator of the computing center, in less than 24 hours, the computed CT angiography will be determined and the patient will be told which treatment center has the capacity based on his insurance. After performing the CT angiography, it will be a maximum of 24 hours to analyze the results, based on which the CT angiography process and hemodynamic parameter calculations will last for 48 hours, and it will be provided to the patient and doctor in the form of a file and a print out.
Computational analysis provides a simple workflow that reduces other unnecessary invasive tests and further radiation exposure and provides more accurate information about their status compared to other non-invasive cardiac tests.
The newly updated ACC/AHA Guidelines reflect the growing support for a Coronary CTA + FFRCT pathway across the world including in Europe (2019 ESC Guidelines), the UK (2016 NICE Guidelines) and Japan (2018 JCS Guidelines) suggesting a revolutionary shift in the diagnosis and management of coronary artery disease (CAD) is underway.
A real world, multi-center, retrospective study including more than 90,000 patients assessing at a national level the incremental impact of adding FFRCT to a CCTA-first diagnostic paradigm for evaluating and managing coronary artery disease (CAD). The study was conducted in England and was funded by UK Medical Research Council (MRC).