CT-FFR and Coronary Revascularization

This chapter explores the role of coronary computed tomography-derived fractional flow reserve (CT-FFR) in guiding coronary revascularization strategies, including percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). It highlights CT-FFR’s utility in noninvasively assessing hemodynamic significance of coronary lesions, optimizing preoperative planning, and predicting post-procedural outcomes. Key advancements include virtual stenting algorithms for simulating PCI outcomes with high diagnostic accuracy (up to 96%) and CT-FFR-guided CABG planning, which improves graft patency by identifying functionally significant lesions. Studies demonstrate that integrating CT-FFR with anatomical data enhances risk stratification, reduces unnecessary interventions, and improves long-term patient prognosis. Ongoing trials, such as FASTTRACK CABG, aim to validate CT-FFR’s clinical efficacy in refining revascularization strategies for complex coronary artery disease.