Diagnostic performance of fractional flow reserve derived from computed tomography in stented coronary arteries

Recently, the application of computational fluid dynamics technology in coronary computed tomographic angiography (cCTA) has enabled noninvasive fractional flow reserve (FFR) computation (FFRCT: fractional flow reserve derived from computed tomography) in patients with coronary artery diseases. 1 Min J.K. Leipsic J. Pencina M.J. et al. Diagnostic accuracy of fractional flow reserve from anatomic CT angiography. JAMA. 2012; 308: 1237-1245 Crossref PubMed Scopus (803) Google Scholar ,2 Nørgaard B.L. Leipsic J. Gaur S. et al. Diagnostic performance of noninvasive fractional flow reserve derived from coronary computed tomography angiography in suspected coronary artery disease: the NXT trial (Analysis of Coronary Blood Flow Using CT Angiography: next Steps). J Am Coll Cardiol. 2014; 63: 1145-1155 Crossref PubMed Scopus (913) Google Scholar However, FFRCT measurement is not currently applied to stented coronary arteries due to challenges in accurately visualizing the luminal boundary within stent segments. On the other hand, recent advances in cardiac computed tomography (CT) might render FFRCT measurement possible in stented coronary arteries. Thus, we aimed to evaluate the feasibility of FFRCT measurement for stented coronary arteries using invasive FFR measured by a pressure wire as a reference standard.