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Case Overview:

A 62 year old man had coronary artery stents placed in his left anterior descending artery and his circumflex artery. He had multiple stenting procedures and presents years later with reoccurrence of lesions as seen on angiography. With coronary angiography providing limited information regarding the significance of a coronary narrowing, fractional flow rate (FFR) is an accurate and lesion-specific test that indicates if a particular coronary stenosis can be held responsible for ischemia. A sensor is introduced proximally and then distally to the lesion, measuring the flow rate pressures in both locations. The FFR is determined and if less than or equal to .74 there is a likelihood that the lesion is causing ischemia. With the FFR for the patient at or above .79, the patient’s FFR did not indicate that there was a likelihood of ischemia at the time of the catheterization. Unfortunately, the patient passed shortly after from a myocardial infarction. The jury found in favor of the defense.