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Fractional Flow Reserve

What is fractional flow reserve?

Fractional flow reserve, or FFR, is a guide wire-based procedure that can accurately measure blood pressure and flow through a specific part of a coronary artery. The measurement of FFR—an index that determines the severity of narrowings in coronary arteries—helps doctors assess whether or not to perform angioplasty or stenting on a blockage to improve blood flow to your heart.

Why is your doctor requesting FFR?

Studies have shown that a functional measurement such as FFR can determine if blood flow is significantly obstructed by a blockage. If flow is not affected, a blockage may not need to be addressed with angioplasty, and a patient may only need a combination of medical therapies such as medication, diet and exercise.

How does FFR work?

A very thin guide wire is inserted through a catheter during an angiogram. This is a smaller catheter than is used for angioplasty and stenting, so it is usually an outpatient procedure. The guide wire is guided into place at the blockage or lesion, and your blood flow is measured. Results are displayed as an “FFR value” on a monitor. An FFR value of less than 0.80 typically requires interventional treatment. Blockages that score higher than 0.80 can generally be treated by medical therapies.

What to wear or bring

Wear comfortable clothing. Before the test, remove any necklaces, bracelets, rings or other jewelry. You should also remove nail polish from your fingernails and toenails.

How long will it take?

The entire procedure usually takes about an hour and a half, but it may take longer if additional tests are required. The length of the test is not an indication of the seriousness of your condition.

What to expect after an FFR

Minor bruising and a small lump or knot (smaller than a quarter) at the insertion site are normal and expected after a catheterization. This should go away in two to six weeks. Check the site occasionally for oozing, swelling or enlarging lump/knot. This is an indication that you are bleeding internally or externally. If this occurs, your physician should be called immediately and you should lay down flat and have someone apply firm pressure on and above the puncture site for 15 to 20 minutes.

Should swelling and bleeding continue as you press, you need to reposition the point of pressure slightly and follow any further instructions your physician has given you. If bleeding persists, you should call 911.

The soreness and bruising should disappear within two weeks. It is normal for the site to feel tender for about a week.

Patients should:

  • Avoid strenuous activity for at least 48 hours.
  • Drink plenty of liquids for several hours after the test to prevent dehydration and help flush the dye out of your body.

Care of your incision:

  • After the procedure, wait 24 hours before showering. Remove the hospital dressing while showering.
  • Gently clean the site using warm, soapy water. Dry thoroughly.
  • Cover the site with a bandage or dressing that covers the entire site
  • Keep the dressing clean and dry to prevent infection. If the bandage becomes wet, remove that one and place a new one.
  • Do not put ointments, oils or lotions on the catheterization site.
  • Do not take baths in a tub (or swim in a pool) for the first seven days.
  • Inspect the site daily.
  • If a closure device was used, please follow the instructions provided.

Call 911 or go to the emergency department of the nearest hospital if you develop:

  • Chest pain
  • Increased shortness of breath
  • Dizziness, trouble speaking or swallowing
  • Loss of feeling in the leg or foot on the side of the catheterization
  • Increased swelling in the groin or leg
  • Unusual groin pain or pain in your right/left leg
  • A redness, swelling, warmth or discharge at the catheter insertion site
  • A fever
  • Bleeding that does not stop after 10 minutes of applying firm pressure directly to the incision

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