The Evolution of Virtual Physiologic Assessments and Virtual Coronary Intervention to Optimize Revascularization
Publication
, Journal Article
Stout, KM; Boudoulas, KD; Povsic, TJ; Altin, SE; Jhand, AS; Bailey, SR; Goldsweig, AM
Published in: Current Cardiovascular Imaging Reports
Purpose of Review: In this review, we summarize the use of virtual physiologic functional assessments of coronary artery disease and their utility to guide virtual coronary intervention (VCI). Recent Findings: Virtual fractional flow reserve (vFFR), coronary angiography–derived fractional flow reserve (FFRangio), virtual contrast FFR (cFFR), and quantitative flow reserve (QFR) are four technologies that generate computer-based FFR measurements comparable to the gold standard of pressure-wire-based FFR. VCI capitalizes on this technology by utilizing pre- and post-vFFR assessments to predict the physiologic response to stenting. Summary: Physiologic assessment of coronary lesion significance has become a cornerstone of decision-making for revascularization. FFR and non-hyperemic pressure ratio use is limited by the requirement for an intracoronary wire and the additional time required. Virtual physiologic assessments address these shortcomings with accuracy comparable to FFR. Building on this technology, VCI simulation has the potential to revolutionize the approach to percutaneous revascularization.
