FFR (Fractional Flow Reserve)

FFR (Fractional Flow Reserve): Pressure-wire derived index to assess functional significance of coronary lesions.

Pressure Measurements (at maximal hyperaemia)

Distal Coronary Pressure — Pd (mmHg)

Aortic Pressure — Pa (mmHg)

Formula

FFR = Pd / Pa

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

Functional assessment of coronary lesion severity during angiography

Decision-making: proceed with PCI vs. defer in intermediate stenosis

Multivessel disease triage (defer non-culprit lesions if FFR >0.80)

Guidance for staged revascularization strategy

≥50% but <90% angiographic stenosis requiring physiologic assessment

Key Points

FFR 0.75–0.80: borderline lesions benefit from serial assessment or iFR

FFR-guided PCI reduces MACE vs. angiography-only guided strategy

ESC/AHA recommend FFR for intermediate coronary lesions

Requires adenosine hyperaemia or equivalent stress; adenosine-free alternatives (iFR, RFR) emerging

How it Works

Formula

FFR = Pd/Pa at maximal hyperaemia Pd = distal coronary pressure (beyond lesion) Pa = aortic pressure (proximal) Normal FFR = 1.0 (no pressure drop) FFR <0.80 = functionally significant lesion (ischaemic)

Interpretation

FFR Value	Clinical Significance	Recommendation
≥0.80	Not ischaemic	Defer PCI; medical therapy
0.75–0.80	Borderline	Consider serial or iFR
<0.75	Ischaemic	PCI recommended
<0.50	Severe ischaemia	PCI strongly indicated

Last Comprehensive Review: 2026-07-17

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

Functional assessment of coronary lesion severity during angiography

Decision-making: proceed with PCI vs. defer in intermediate stenosis

Multivessel disease triage (defer non-culprit lesions if FFR >0.80)

Guidance for staged revascularization strategy

≥50% but <90% angiographic stenosis requiring physiologic assessment

Key Points

FFR 0.75–0.80: borderline lesions benefit from serial assessment or iFR

FFR-guided PCI reduces MACE vs. angiography-only guided strategy

ESC/AHA recommend FFR for intermediate coronary lesions

Requires adenosine hyperaemia or equivalent stress; adenosine-free alternatives (iFR, RFR) emerging

How it Works

Formula

Interpretation

FFR Value	Clinical Significance	Recommendation
≥0.80	Not ischaemic	Defer PCI; medical therapy
0.75–0.80	Borderline	Consider serial or iFR
<0.75	Ischaemic	PCI recommended
<0.50	Severe ischaemia	PCI strongly indicated

Last Comprehensive Review: 2026-07-17

In Recent Clinical News

Scanning Medical Journals

No new significant updates or guidelines matching this topic were found today. We will check again soon.

FFR (Fractional Flow Reserve)

When to Use

When to Use

Key Points

How it Works

Formula

Interpretation

Clinical Pearls

Technical Pearls

Clinical Gotchas

Next Steps

FFR ≥0.80 (Not Ischaemic)

FFR 0.75–0.80 (Borderline)

FFR <0.75 (Ischaemic)

Complementary Calculators

The Evidence

Landmark Trials

Origins & History

Development

When to Use

When to Use

Key Points

How it Works

Formula

Interpretation

Clinical Pearls

Technical Pearls

Clinical Gotchas

Next Steps

FFR ≥0.80 (Not Ischaemic)

FFR 0.75–0.80 (Borderline)

FFR <0.75 (Ischaemic)

Complementary Calculators

The Evidence

Landmark Trials

Origins & History

Development

In Recent Clinical News

FFR (Fractional Flow Reserve)

When to Use

When to Use

Key Points

How it Works

Formula

Interpretation

Clinical Pearls

Technical Pearls

Clinical Gotchas

Next Steps

FFR ≥0.80 (Not Ischaemic)

FFR 0.75–0.80 (Borderline)

FFR <0.75 (Ischaemic)

Complementary Calculators

The Evidence

Landmark Trials

Origins & History

Development

When to Use

When to Use

Key Points

How it Works

Formula

Interpretation

Clinical Pearls

Technical Pearls

Clinical Gotchas

Next Steps

FFR ≥0.80 (Not Ischaemic)

FFR 0.75–0.80 (Borderline)

FFR <0.75 (Ischaemic)

Complementary Calculators

The Evidence

Landmark Trials

Origins & History

Development

In Recent Clinical News