Usually the decision to stent a coronary vessel is primarily determined by the % stenosis of the vessel. In this RCT of >1000 patients, they were randomized to stenting according to angiography alone, or to angiography in addition to the Fractional Flow Reserve (FFR; ratio of maximal blood flow in a stenotic vessel versus normal maximal blood flow). In the FFR group, the vessel was stented only if the FFR was <0.8. The numbers of stents per patient in the standard group was 2.7, versus 1.8 in the FFR group. The primary endpoint (1-year death, MI, or re-vascularization) occured in 18% of the standard group and only 13% of the FFR group. We should be aware that using FFR in addition to standard angiography will likely be used to guide stenting decisions in the cath lab. (abstract)
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