FFR to assess need for a side branch stent

Fractional flow reserve (FFR) estimation using the Doppler wire is useful in assessing the need for a side branch stent in bifurcation disease. Usually a stent is considered in bifurcation disease only if the side branch is large and almost equal in size to the distal vessel. Using a side branch stent increases the risk of stent thrombosis in the main vessel and is especially to be avoided in a thrombotic situation as in acute myocardial infarction. If an FFR is available, it can measure the pressure difference across the lesion and if the distal pressure is more than 0.75 times the proximal pressure (FFR >0.75) a side branch stent is considered unnecessary.