Fractional Flow Reserve (FFR) | Tampa General Hospital

Fractional Flow Reserve (FFR) 

Fractional flow reserve (FFR) is a wire-based diagnostic procedure that measures blood pressure and blood flow using a specific part of the coronary artery. A relatively new procedure, FFR was developed in the 1990s and measures the maximum achievable blood flow in a blocked coronary artery and the theoretical maximum blood flow in a normal coronary artery. Together, these numbers form a ratio. If the ratio is lower than .8, the FFR is considered abnormal.  

What Does FFR Diagnose? 

FFR is most commonly used to assess blockages caused by coronary artery disease to determine whether or not a patient needs to undergo percutaneous coronary intervention (PCI)—angioplasty combined with a stenting procedure. It provides a more accurate assessment than angiography alone.  

How Is FFR Performed? 

Most often, the fractional flow reserve procedure is combined with a coronary angiography. FFR uses a small wire (0.014”) that has a pressure sensor to measure blood flow and blood pressure. During the procedure, a physician will insert this wire through a catheter to reach the diseased artery, where the wire will then obtain the measurements. The results are typically displayed immediately, allowing the physician to make prompt treatment decisions. If the FFR is in the normal range (above .8), the physician will typically recommend medication therapy. 

What to Expect 

FFR is considered the gold standard for evaluating coronary artery disease. Considering that it is performed in conjunction with angiography, it does not add significant time or require other invasive measures to obtain the results.  

Other advantages of FFR include: 

  • It can be measured successfully in 99% of arteries. 
  • Its values are not affected by changes in heart rate, heart contractions or blood pressure. 
  • It has a unique characteristic of being measured with a 1.0 value in normal coronary arteries. 

    There are times when the results of FFR and the results of angiography are contradictory—either the angiography shows significant blockage and the FFR ratio is in the normal range, or the opposite occurs, mild blockage with a low FFR. In these cases, it’s generally agreed that using the FFR result is more accurate and should guide treatment decisions. 


    FFR is a breakthrough diagnostic technique that allows cardiologists and vascular specialists to provide better, more accurate analyses of coronary artery disease. Tampa General Hospital is one of the few hospitals in the regions offering this procedure, one of our many advanced diagnostic options.