Limitations and Pitfalls of Fractional Flow Reserve Measurements and Adenosine-Induced Hyperemia

Abstract

Coronary hemodynamic measurements provide a critical tool to assess the ischemic potential of coronary stenoses. Fractional flow reserve (FFR) is a reliable method to relate translesional coronary pressures to hyperemic myocardial blood flow. Although a basic understanding in FFR can be quickly achieved, many of the nuances and potential pitfalls require special attention. The authors discuss the practical setup of coronary pressure measurement, the most common pitfalls in technique and ways to avoid them, and the limitations of available pharmacologic hyperemic methods.

Keywords: Adenosine-induced hyperemia; Coronary stenosis; Fractional flow reserve; Ischemic coronary artery disease; Limitations.