FFRCT in Practice: Advancing CCTA Interpretation and Clinical Decision-Making-Video - FFRCT in Practice: Advancing CCTA Interpretation and Clinical Decision-Making

Video - FFRCT in Practice: Advancing CCTA Interpretation and Clinical Decision-Making

Video Transcription

Video Summary

Dr. Ron Blankstein discusses the clinical application of FFRCT (fractional flow reserve computed tomography) in coronary CT angiography to assess moderate coronary stenoses of uncertain hemodynamic significance. Using case studies, he illustrates how FFRCT, derived from standard CTA images without additional radiation, helps determine if lesions restrict blood flow. An FFRCT >0.8 generally indicates non-flow limiting lesions, guiding clinicians to intensify medical therapy instead of invasive procedures. He emphasizes combining FFRCT with quantitative plaque analysis enhances risk stratification and decision-making. Evidence from registries and trials like ADVANCE, PRECISION, and UK observational studies supports FFRCT’s safety, diagnostic accuracy, and reduction of unnecessary invasive angiography. Guidelines recommend FFRCT or stress testing for lesions with 40-90% stenosis in symptomatic patients, especially in proximal vessels. Key points include selecting FFRCT based on lesion characteristics, proper measurement protocols, and interpreting borderline values. Overall, FFRCT is a valuable, non-invasive tool that improves individualized management of coronary artery disease.

Keywords

FFRCT

coronary CT angiography

fractional flow reserve

coronary stenosis assessment

non-invasive cardiac imaging

coronary artery disease management