{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:53:59Z","timestamp":1787018039941,"version":"build-2736575974"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      Invasive fractional flow reserve (FFR\n                      <jats:sub>INV<\/jats:sub>\n                      ) is the standard technique for assessing myocardial ischemia. Pressure distortions and measurement location may influence FFR\n                      <jats:sub>INV<\/jats:sub>\n                      interpretation. We report a technique for performing invasive fractional flow reserve (FFR\n                      <jats:sub>INV<\/jats:sub>\n                      ) by minimizing pressure distortions and identifying the proper location to measure FFR\n                      <jats:sub>INV<\/jats:sub>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      FFR\n                      <jats:sub>INV<\/jats:sub>\n                      recordings were obtained prospectively during manual hyperemic pullback in 100 normal and diseased coronary arteries with single stenosis, using 4 measurements from the terminal vessel, distal-to-the-lesion, proximal vessel, and guiding catheter. FFR\n                      <jats:sub>INV<\/jats:sub>\n                      profiles were developed by plotting FFR\n                      <jats:sub>INV<\/jats:sub>\n                      values (\n                      <jats:italic>y<\/jats:italic>\n                      -axis) and site of measurement (\n                      <jats:italic>x<\/jats:italic>\n                      -axis), stratified by stenosis severity. FFR\n                      <jats:sub>INV<\/jats:sub>\n                      \u22640.8 was considered positive for lesion-specific ischemia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Erroneous FFR\n                      <jats:sub>INV<\/jats:sub>\n                      values were observed in 10% of vessels because of aortic pressure distortion and in 21% because of distal pressure drift; these were corrected by disengagement of the guiding catheter and re-equalization of distal pressure\/aortic pressure, respectively. There were significant declines in FFR\n                      <jats:sub>INV<\/jats:sub>\n                      from the proximal to the terminal vessel in normal and stenotic coronary arteries (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). The rate of positive FFR\n                      <jats:sub>INV<\/jats:sub>\n                      was 41% when measured from the terminal vessel and 20% when measured distal-to-the-lesion (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001); 41.5% of positive terminal measurements were reclassified to negative when measured distal-to-the-lesion. Measuring FFR\n                      <jats:sub>INV<\/jats:sub>\n                      20 to 30 mm distal-to-the-lesion (rather than from the terminal vessel) can reduce errors in measurement and optimize the assessment of lesion-specific ischemia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      Meticulous technique (disengagement of the guiding catheter, FFR\n                      <jats:sub>INV<\/jats:sub>\n                      pullback) is required to avoid erroneous FFR\n                      <jats:sub>INV<\/jats:sub>\n                      , which occur in 31% of vessels. Even with optimal technique, FFR\n                      <jats:sub>INV<\/jats:sub>\n                      values are influenced by stenosis severity and the site of pressure measurement. FFR\n                      <jats:sub>INV<\/jats:sub>\n                      values from the terminal vessel may overestimate lesion-specific ischemia, leading to unnecessary revascularization.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circinterventions.119.007939","type":"journal-article","created":{"date-parts":[[2019,10,14]],"date-time":"2019-10-14T05:00:28Z","timestamp":1571029228000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Optimizing the Technique for Invasive Fractional Flow Reserve to Assess Lesion-Specific Ischemia"],"prefix":"10.1161","volume":"12","author":[{"given":"Brian M.","family":"Renard","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, William Beaumont Hospital, Royal Oak, MI."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elvis","family":"Cami","sequence":"additional","affiliation":[{"name":"Department 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MI."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Berman","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, William Beaumont Hospital, Royal Oak, MI."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akhil","family":"Gulati","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, William Beaumont Hospital, Royal Oak, MI."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maher","family":"Rabah","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, William Beaumont Hospital, Royal Oak, MI."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Timmis","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, William Beaumont Hospital, Royal Oak, MI."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazen","family":"Shoukfeh","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, William Beaumont Hospital, Royal Oak, MI."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amr E.","family":"Abbas","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, William Beaumont Hospital, Royal Oak, MI."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Hanzel","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, William Beaumont Hospital, Royal Oak, MI."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Hanson","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, William Beaumont Hospital, Royal Oak, 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