Assessing Hemodynamic Improvements in Peripheral Arterial Interventions: The Role of Resting Fractional Flow Reserve (rFFR) with Zurich Medical's Pressure Guidewire System

Peripheral arterial disease (PAD) is a prevalent and debilitating condition characterized by progressive arterial stenosis that compromises blood flow to the lower extremities, leading to claudication, ischemia, and, in severe cases, limb-threatening complications. Traditional methods of assessing arterial lesions primarily rely on angiographic imaging, which, while useful for anatomical evaluation, does not provide direct physiological insights into the func- tional severity of stenosis or the hemodynamic impact of interventions. Resting fractional flow reserve (rFFR) has emerged as a promising tool for quantifying pressure gradients across stenotic lesions in real time, offering a more precise and objective measure of lesion severity and post-treatment efficacy.This prospective, observational study was conducted at a single high-volume interven- tional center: Vascular and Interventional Specialists (Dakota Dunes, SD). The study aimed to evaluate the effectiveness of rFFR in assessing hemodynamic changes before and after pe- ripheral arterial interventions, using Zurich Medical’s pressure wire system. The primary objective was to determine the degree of improvement in rFFR pre and post-treatment and its correlation with procedural success, while the secondary objectives included assessing the feasibility of rFFR measurements across different intervention modalities, such as balloon angioplasty, atherectomy, drug-coated balloons, and stenting