A new minimally invasive method for assessing blood flow restriction in coronary arteries, known as vessel fractional flow reserve (vFFR), showed similar outcomes to the standard invasive procedure, according to results presented on Mar. 29 at the American College of Cardiology's Annual Scientific Session.
The findings are significant because they suggest that vFFR could make it easier and less risky for patients with heart disease to be evaluated for blocked arteries. The technique uses computer analysis of three-dimensional images from a coronary angiogram rather than inserting a wire or catheter into the artery, which is required in conventional fractional flow reserve (FFR) procedures.
"Our new method produced very similar outcomes at one year compared with the standard of care," said Joost Daemen, MD, PhD, associate professor in the Department of Cardiology at Erasmus University Medical Center and first author of the study. "We have also shown that this technique can easily be incorporated into routine clinical practice."
The FAST-III trial enrolled 2,235 patients across seven European countries who were randomly assigned to receive either conventional FFR or vFFR assessment. Most participants had chest pain linked to exertion or stress; others were at high risk for heart attack or had already experienced one. After testing, those with positive results received either percutaneous coronary intervention (PCI) or bypass surgery. At one year, both groups saw a primary endpoint event rate of 7.5%. Study vessel failure occurred in 4% of vFFR patients versus 4.6% among those assessed by traditional FFR.
Daemen said that while the study was not blinded and only a minority presented with acute heart attacks—both limitations—the data support further investigation into cost savings and broader use for vFFR compared with conventional methods.
The research was funded by Pie Medical Imaging and Siemens Healthineers AG and published online simultaneously in the New England Journal of Medicine.
