Ask Dr. Z

Our physicians utilize structured reporting, and certain phrases are made up to select to insert into the cath report. We have a phrase that says “iFR/FFR”, which indicates that one or the other was performed. Then it’s supposed to clarify which one was performed with the appropriate documentation. The question we have is in regards to the use of nitroglycerin, as we know that this can be used possibly for FFR per Q&A #14476. Would the verbiage in italics be an iFR and an FFR, or is it only an iFR? “Mid LAD lesion is 60% stenosed. The lesion is eccentric. The lesion is moderately calcified. iFR was measured. iFR ratio: 0.93. Other iFR .94 Nitroglycerin was given by intracoronary injection. The pressure wire was then advanced and appropriately normalized. After IFR/FFR was assessed, with the transducer in the distal vessel well beyond the area in question, the wire was withdrawn and there was no drift. There was TIMI 3 flow and no evidence of dissection on repeat injection.”