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Coronary CT-derived Fractional Flow Reserve (FFR-CT)

Computational fluid dynamics from coronary CT angiography to estimate hemodynamic significance of stenosis.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Radyoloji department. Book Appointment →

What is Coronary CT-derived Fractional Flow Reserve (FFR-CT)?

FFR-CT (CT-derived fractional flow reserve) applies computational fluid dynamics, often AI-accelerated, to standard coronary CT angiography data to model rest and hyperemic blood flow without additional contrast, radiation or vasodilators.

It produces lesion-specific FFR values along the entire coronary tree. Values <=0.80 indicate hemodynamically significant stenosis warranting revascularization, while values >0.80 support deferred medical therapy.

Pivotal trials (PLATFORM, ADVANCE, FORECAST) established that FFR-CT reduces unnecessary invasive angiography, improves diagnostic accuracy in intermediate stenoses (40-90%), and is now embedded in NICE, ESC and AHA guidelines for stable chest pain evaluation.

Symptoms

Stable angina or atypical chest pain
Intermediate coronary stenosis (40-90%) on CCTA
Need to defer or accelerate invasive angiography
Multivessel disease requiring functional triage
Patient unable to tolerate invasive procedures
Pre-TAVR or pre-noncardiac surgery assessment
Inconclusive stress imaging
Uncertain clinical relevance of imaging stenosis

Risk Factors

Stable chest pain with intermediate pretest probability
Intermediate coronary stenoses on CCTA
Diabetes with multivessel disease
Prior coronary stents requiring functional follow-up
Pre-operative cardiovascular risk evaluation
Inability to undergo stress testing
Renal insufficiency limiting contrast use
Need to avoid invasive angiography

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Stable chest pain with intermediate stenosis on CCTA
  • Need for hemodynamic evaluation without invasive angiography
  • Multivessel disease decisions
  • Inconclusive functional imaging
  • Pre-TAVR or pre-major-surgery cardiac evaluation
  • Tertiary center referral for advanced cardiac CT analysis

Treatment Methods

01
Coronary CT angiography acquisition meeting quality standards
02
FFR-CT computation by certified vendor (HeartFlow or comparable)
03
Lesion-specific FFR reporting along all major branches
04
Multidisciplinary heart team interpretation
05
Optimization of medical therapy if FFR-CT >0.80
06
Targeted invasive angiography and revascularization if FFR-CT <=0.80
07
Repeat after PCI for residual ischemia assessment
08
Quality control and operator training

Which Department to Visit?

You can visit our Radyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.