Category Archives: Angiograms

Fractional Flow Reserve: A “How-To” Guide for Cardiologists

Fractional Flow Reserve wire in arteryI’ve written a lot about Fractional Flow Reserve, or FFR, in the past — and the fact that it’s a simple tool that can be used during an angiogram to assess the actual obstruction to the volume of blood flow being caused by an arterial blockage. Sure you can SEE a blockage on the fluoroscopic image, but should you stent it?

The results of the by now well-known FAME study indicate that a third of the blockages between 50% and 90% (as seen on the angiogram) actually had an FFR measurement of greater than 80% (meaning that the obstruction of flow was less than 20%, even though the blockage looked more significant on the angiogram). Most importantly, treating those blockages with angioplasty and stenting resulted in worse outcomes at one year — results which have remained constant now three years later. For more information, read our exclusive interview with Dr. Nico Pijls, co-principal investigator for FAME. Continue reading

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Filed under Angiograms, FAME I / FAME II, FFR

Stent Accusations: The U.S. Senate Tries to Drum Up COURAGE

Stent and the SenateMonday’s 172-page Senate Finance Committee Staff Report on the overuse of coronary stents by Dr. Mark Midei at St. Joseph’s Hospital in Maryland has been all over the news — over 300 articles to date, claiming fraud, malpractice, pig roasts, threats to reporters — all of which serve to rekindle the “anti-stent” sentiment that followed on the heels of the COURAGE study back in 2007. In fact, Dr. William Boden, principal investigator for COURAGE, was interviewed for the Senate report, which characterized him as follows: Continue reading

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Filed under Angiograms, COURAGE, Drug-Eluting Stents, FFR, Interviews, Media Coverage