Comparison Of On-site Clinician-operated Computational Fluid Dynamic 3Rd Generation Cffr For The Detection Of Lesion-specific Ischemia Compared To Invasive Ffr.

Abstract

Introduction: CT coronary angiogram (CCTA) is highly sensitive for the presence of coronary atherosclerosis, with NPV approaching 100%. Specificity, however, is relatively modest leading to false-positive reads and unnecessary catheterizations. CT based FFR (FFRct) allows for non-invasive quantitation of the haemodynamic implications of coronary stenosis and has been shown to improve specificity with no reduction in sensitivity. We utilised a prototype application that allows for onsite CT derived fractional flow reserve (FFR) determination using a desktop computer (“cFFR” Siemens Healthineers, Forchheim, Germany). This prototype decreases model complexity using a 1D-3D hybrid approach, with complex 3D modelling applied only to the stenotic segments 1. We compared cFFR to invasively measured metrics of lesion-specific ischaemia (FFRcath) in patients with positive CCTA reads.