https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2813462
Although FFR-guided treatment is the standard approach in patients with intermediate coronary stenosis, 3,4 clinical events still occur in medically treated patients whose PCI was deferred because of FFR findings, 8 and this observation is similar when imaging criteria are applied for deferral of PCI. 6,7 Considering prior studies have

https://www.nejm.org/doi/full/10.1056/NEJMoa2201546
The frequency of PCI was 44.4% among patients in the FFR group and 65.3% among those in the IVUS group. At 24 months, a primary-outcome event had occurred in 8.1% of the patients in the FFR group

https://www.acc.org/About-ACC/Press-Releases/2022/04/04/14/34/FFR-Guided-PCI-Non-Inferior-to-IVUS-in-Intermediate-Coronary-Stenosis
By contrast, intravascular ultrasound (IVUS) uses sound waves to see the interior of the artery and the buildup of plaques on the artery's walls. Previous studies, including some conducted in patients with intermediate coronary stenosis, had shown that both FFR-guided and IVUS-guided PCI produced better patient outcomes than angiography

https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.123.013308
In a previous study by Nam et al, IVUS-guided treatment decision-making resulted in higher rates of revascularization than FFR-guided treatment decision-making in 167 patients with intermediate coronary artery stenosis; however, there was no significant difference in major adverse cardiac event rates between the 2 groups at 1 year. 25 The

https://www.nejm.org/doi/full/10.1056/NEJMc2212953
Although FFR-guided PCI has an established role among patients with intermediate coronary stenosis and stable ischemic heart disease, 2 whether IVUS has a similar role is unclear, except in those

https://www.radcliffecardiology.com/video-index/acc-22-ffr-vs-ivus-guided-pci-intermediate-coronary-artery-stenosis-flavour-trial
I can summarise the key results of our study as: in patients who have an intermediate degree of stenosis, in comparison with the IVUS-guided PCI, FFR-guided PCI was noninferior, with respect to a clinical endpoint and FFR-guided PCI was associated with a low rate of stent implantation, without the difference in patient-reported outcomes between

https://www.acc.org/latest-in-cardiology/clinical-trials/2022/04/02/16/16/flavour
Patients with an intermediate coronary stenosis were randomized to FFR (n = 838) vs. IVUS (n = 844). In the FFR group, percutaneous coronary intervention (PCI) was indicated if FFR ≤0.8 and considered optimized if post-PCI FFR ≥0.88. In the IVUS group, PCI was indicated if minimal luminal area (MLA) ≤3 mm 2, or >3 to 4 mm 2 with plaque

https://www.acc.org/latest-in-cardiology/articles/2022/04/03/13/22/mon-11am-flavour-acc-2022
In patients with intermediate coronary stenosis, fractional flow reserve (FFR)-guided PCI was noninferior to intravascular ultrasound (IVUS)-guided PCI, according to findings from the FLAVOUR trial presented April 4 at ACC.22.The study is the first large, randomized head-to-head comparison of two methods of evaluating patients' need for a stent in their coronary artery.

https://www.jacc.org/doi/10.1016/j.jcin.2010.04.016
The study included 167 consecutive patients, with intermediate coronary lesions evaluated by FFR or IVUS (FFR-guided, 83 lesions vs. IVUS-guided, 94 lesions). Cutoff value of FFR in FFR-guided PCI was 0.80, whereas that for minimal lumen cross sectional area in IVUS-guided PCI was 4.0 mm 2 .

https://medicalxpress.com/news/2022-04-ffr-guided-pci-non-inferior-ivus-intermediate.pdf
Koo. However, FFR-guided and IVUS-guided PCI had not been compared head-to-head. The study enrolled 1,682 patients with intermediate coronary stenosis. The average age of patients was 65 and 71%

https://www.ahajournals.org/doi/abs/10.1161/CIRCINTERVENTIONS.123.013308
Outcomes of percutaneous coronary intervention in intermediate coronary artery disease: fractional flow reserve-guided versus intravascular ultrasound-guided. JACC Cardiovasc Interv. 2010; 3:812-817. doi: 10.1016/j.jcin.2010.04.016 Crossref Medline Google Scholar; 26.

https://scai.org/comparison-fractional-flow-reserve-guided-and-intravascular-ultrasound-guided-percutaneous-coronary
First, head-to-head comparison of FFR guided vs IVUS guided PCI for intermediate coronary lesions. What did the study show? Clinical trial randomizing1682 stable coronary artery disease (CAD) patients, mean age of 65 with diabetes in 32.9 %, to either an FFR guided or IVUS guided PCI in a 1:1 ratio.

https://www.nejm.org/doi/full/10.1056/NEJMoa2314149
The use of fractional flow reserve (FFR), a wire-based technique that evaluates functional lesion severity, to guide PCI has been shown to result in a lower risk of serious adverse events than

https://pubmed.ncbi.nlm.nih.gov/20723852/
Objectives: This study sought to evaluate the long-term clinical outcomes of a fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) strategy compared with intravascular ultrasound (IVUS)-guided PCI for intermediate coronary lesions. Background: Both FFR- and IVUS-guided PCI strategies have been reported to be safe and effective in intermediate coronary lesions.

https://www.ahajournals.org/doi/10.1161/JAHA.121.023481
Intravascular ultrasound (IVUS) provides detailed guidance of percutaneous coronary intervention (PCI) from pre‐interventional lesion characterization, including plaque morphology, lesion length, and reference vessel diameter, to post‐interventional IVUS to assess the stent result including minimal stent area and stent expansion. 1 As a result, IVUS‐guided drug‐eluting stent (DES

https://www.jacc.org/doi/10.1016/j.jcin.2022.06.018
Methods. The FFR REACT study is an investigator-initiated, single-center, double-blind, parallel-arm trial that randomized patients with a post-PCI FFR <0.90 in a 1:1 ratio to IVUS-guided PCI optimization or the standard of care (the control arm [ie, the end of the procedure]) between October 31, 2017, and April 22, 2020.

https://www.practiceupdate.com/content/ffr-guided-vs-ivus-guided-pci-in-intermediate-coronary-artery-stenosis/135498
Dr. Herrmann: The primary outcome of the study was the composite of all-cause mortality, MI, and revascularization, this occurred in 8.1% in the FFR, and 8.5% in the IVUS group. And that met statistical criteria for non-inferiority. There was no difference in secondary outcomes either including MI or revascularization at 24 months, and patient

https://www.acc.org/latest-in-cardiology/journal-scans/2022/09/20/19/43/instantaneous-wave-free-ratio-tct-2022
Among patients with intermediate left main coronary artery (LMCA) stenosis, concordance between FFR and iFR was moderate (80%). In case of discordance, IVUS tended to be more similar to FFR to classify stenosis significance. Deferral of LMCA revascularization based on iFR (combined with IVUS in cases of FFR and iFR discordance) appears to be safe.

https://www.nejm.org/doi/full/10.1056/NEJMoa1616540
The instantaneous wave-free ratio (iFR) is an index used to assess the severity of coronary-artery stenosis. The index has been tested against fractional flow reserve (FFR) in small trials, and

https://pubmed.ncbi.nlm.nih.gov/29754669/
Background: Coronary angiography has limitations in defining the ischemia-causing stenotic lesion, especially in cases with intermediate coronary stenosis. Fractional flow reserve (FFR) is a current standard method to define the presence of ischemia, and intravascular ultrasound (IVUS) is the most commonly used invasive imaging tool that can provide the lesion geometry and can provide the

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820232
Percutaneous coronary intervention (PCI) is a standard treatment option for coronary artery disease. 1,2 Even though ischemia-guided PCI is endorsed by class IA recommendation, adverse clinical events still occur in approximately 10% of patients after the procedure. 1-4 Traditionally, angiographically successful PCI has been defined as a

https://www.acc.org/latest-in%20cardiology/articles/2016/06/13/10/01/ivus-in-pci-guidance/
Figure 2: Meta-Analyses of IVUS Versus Angiography-Guided DES. Five meta-analyses of up to 3 RCTs and 17 registry studies have shown that IVUS guided DES implantation was associated with a reduction in MACE including mortality, myocardial infarction, ST, and repeat revascularization. Figure 3: MACE in Seven Studies of IVUS Versus Angiography

https://www.jacc.org/doi/10.1016/j.jcin.2022.07.010
Approximately three-fourths of the lesions were in the left anterior descending coronary artery (LAD), which may indicate that FFR ≥0.90 was not easily obtained for LAD lesions in general. ... optical coherence tomography-guided or angio-guided PCI. 11 Therefore, IVUS-directed optimization of stent treatment is 1 of the most promising

https://www.acc.org/latest-in-cardiology/journal-scans/2023/08/30/14/32/sex-differences-in-ffr-esc-2023
The main findings were as follows: 1) Despite visually comparable % of diameter stenosis between sexes, an in-depth evaluation by FFR or IVUS showed less severe disease burden in women than that in men. 2) Women had a lower rate of PCI than men, which was attributed to the difference in patients guided by FFR.

https://www.acc.org/latest-in-cardiology/articles/2024/06/20/12/51/ffr-ifr-are-the-published-cutoffs-applicable-in-athletes
FFR is a physiologic index derived by comparing the pressures proximal and distal to a focal coronary stenosis during maximal vasodilation, achieved with the infusion of adenosine. 5 Under low and constant resistance, the pressure gradient becomes a surrogate for flow, allowing the severity of stenosis to be better defined by quantitatively