FLAVOUR II: A Brief Intro to the FFR and IVUS-Guided Intervention Strategy for Clinical Outcomes in Patients With Intermediate Stenosis
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At CRT 2025 in Washington, D.C., Dr. Morton J. Kern offered his prediction around the FLAVOUR II trial: would AI-driven angioFFR prove to be noninferior to intravascular ultrasound (IVUS) in guiding percutaneous coronary intervention for angiographically significant lesions?
Listen to Dr. Kern's prediction at CRT and then beneath the video, find out the answer, as presented at ACC.25.
Was Dr. Kern accurate in his prediction?
The FLAVOUR II trial was presented just weeks later at ACC.25 in Chicago in a Late-Breaking Clinical Trial session.
FLAVOUR II is the first large-scale, randomized trial to pit artificial intelligence against a gold standard imaging modality in over 1,800 patients with de novo coronary lesions across 22 centers in China. Patients were randomized to PCI guided by either angioFFR, a single-view, AI-powered angiographic fractional flow reserve (FFR) tool, or IVUS, with the goal of evaluating safety, efficacy, and resource utilization.
The results? Dr. Kern was correct! AngioFFR-guided PCI achieved noninferior outcomes at 12 months compared to IVUS-guided PCI in terms of death, MI, or repeat revascularization. Interestingly, angioFFR led to fewer stent implantations and reduced use of antiplatelet therapy.
As a potential disruptive force in physiology-guided PCI, AngioFFR could reduce time, contrast, and cost, all while expanding access to physiologic assessment in labs where pressure wires or IVUS may not be available.
References
1. Hu X, Zhang J, Yang S, Jiang J, Peng X, Lu D, Pan Y, Guo L, Li J, He W, Zhou H, Pu J, Huang J, Jiang F, Liu Q, Song D, Lu L, Cheng Z, Yang B, Ma J, Chen P, Li S, Meng Z, Tang L, Fan Y, Shin ES, Tu S, Nam CW, Fearon WF, Koo BK, Wang J; FLAVOUR II study group. Angiography-derived fractional flow reserve versus intravascular ultrasound to guide percutaneous coronary intervention in patients with coronary artery disease (FLAVOUR II): a multicentre, randomised, non-inferiority trial. Lancet. 2025 Mar 28:S0140-6736(25)00504-5. doi: 10.1016/S0140-6736(25)00504-5. Epub ahead of print.
2. Yang S, Kang J, Hwang D, Zhang J, Jiang J, Hu X, Hahn JY, Nam CW, Doh JH, Lee BK, Kim W, Huang J, Jiang F, Zhou H, Chen P, Tang L, Jiang W, Chen X, He W, Ahn SG, Yoon MH, Kim U, Lee JM, Ki YJ, Shin ES, Kim HS, Tahk SJ, Wang J, Koo BK. Physiology- or Imaging-Guided Strategies for Intermediate Coronary Stenosis. JAMA Netw Open. 2024 Jan 2;7(1):e2350036. doi: 10.1001/jamanetworkopen.2023.50036
Find More:
Grand Rounds With Morton Kern, MD
Peripheral Artery Disease Topic Center
