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When are fractional flow rate (FFR) and intravascular ultrasound (IVUS) tests appropriate?
Hi, I was wondering why fractional flow rate and intravascular ultrasound are not done with blockages that are under 50? I had bypass in 2005 for a block of the left main. In 2006, I had a stent put in the left main as they said the LIMA graft failed to mature. I have 30 percent blockage in the RCA, 40 in the circumflex and 30 throughout the LAD. I have chronic chest pain down my left arm across my chest when walking. I have been just diagnosed with small vessel disease and understand this can cause my symptoms. I was hoping they would do these tests with my cath. Is the intravascular test something that I should try to get at some point? Thank you.
submitted by Chris from Illinois on 9/4/2013
by Texas Heart Institute cardiologist, Neil E. Strickman, MD
Great question. Intravascular Ultrasound [IVUS] and Fractional Flow Rate [FFR] have been studied extensively. It is well documented that an FFR <80% is predictable that the blockage, if fixed, will benefit the patient. If FFR is > 80%, there is no benefit to fixing the blockage. This and IVUS correlate very well with the fact that it takes at least a 70% narrowing to cause clinical concern. These tests are expensive, thus cost becomes an issue if not clinically indicated. Good luck.
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Updated September 2013