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FFR-CT for the Selection of a Patient and Vessel for Revascularization: A Case Report

ABSTRACT Stable chest pain has traditionally been assessed using tests that visualize the physiologic response to stress on the myocardium or, more recently, coronary anatomy with non-invasive coronary computed tomography angiography. Either basic approach has advantages and disadvantages relative to diagnostic and therapeutic decision-making. Improved patient outcomes have been achieved with an invasive anatomic assessment using coronary angiography followed by stenosis specific intervention guided by physiologic measurements using invasive fractional flow reserve. Fractional flow reserve computed tomography has been developed to mimic these invasive procedures using noninvasive coronary computed tomography angiography and computer modeling with computational fluid dynamics. We present a case of a man who had stenoses in 2 separate vessels and who received a stent in only the one that was physiologically important on fractional flow reserve computed tomography.