Medis QFR®

Clinical Evidence

Step into the heart of QFR® with our clinical evidence collection. These publications aren’t just papers; they’re a window into the world of QFR® as it works in real-life Cath labs. Dive deep into the studies, analyses, and findings that make QFR® an essential tool in interventional cardiology. This is your key to understanding the practical impact of QFR. Join us on this journey through the data, and unlock the knowledge that’s shaping how we assess coronary physiology.

Major Updates on Medis QFR® in the 2024 ESC Guidelines

Christiaan Vrints, Felicita Andreotti, Konstantinos C. Koskinas, Xavier Rossello, Marianna Adamo, James Ainslie, Adrian Paul Banning, Andrzej Budaj, Ronny R. Buechel, Giovanni Alfonso Chiariello, Alaide Chieffo, Ruxandra Maria Christodorescu, Christi Deaton, Torsten Doenst, Hywel W. Jones, Vijay Kunadian, Julinda Mehilli, Milan Milojevic, Jan J. Piek, Francesca Pugliese, Andrea Rubboli, Anne Grete Semb, Roxy Senior, Jurrien M. ten Berg, Eric Van Belle, Emeline M. Van Craenenbroeck, Rafael Vidal-Perez, Simon Winther, and ESC Scientific Document Group


The 2024 ESC guidelines have introduced important updates for Medis QFR®, highlighting its role in three key areas of cardiac care. First, Medis QFR® received a Class IB recommendation for assessing epicardial artery stenosis. This technology, which utilizes 3D QCA and flow velocity, provides a clear advantage over angiography-based FFR methods, which only have a Class IIb/C recommendation. Studies confirm that using QFR® to guide interventions reduces the rates of myocardial infarctions and ischemia-driven revascularizations, demonstrating that this method is more effective than visual assessments of angiograms. Medis QFR® is designed for both prospective/immediate and retrospective data analysis, offering a comprehensive physiology platform.

Second, Medis QFR® now has a Class IA recommendation for selecting lesions in patients with multivessel disease, enabling detailed examinations of multiple vessels and lesions using only angiograms. This approach helps reduce the risks associated with inserting pressure wires and cuts down on costs.

Additionally, for managing chronic coronary syndrome in patients with chronic heart failure, Medis QFR® is recommended with a Class IC for those with a left ventricular ejection fraction over 35% and a high likelihood of obstructive coronary artery disease. The guidelines also highlight the expanded understanding of coronary syndromes, recognizing the significance of both macrovascular and microvascular abnormalities that can lead to myocardial ischemia. Notably, Medis QFR® integrates features like the angiography-derived index of coronary microcirculatory resistance (angio-IMR), which assesses microcirculation without the need for intracoronary wires, offered via QFR-IMR®.

QFR based virtual PCI or Conventional Angiography to guide PCI: the AQVA Trial

Biscaglia et al. 2023

The AQVA (Angio-based Quantitative Flow Ratio Virtual PCI Versus Conventional Angio-guided PCI in the Achievement of an Optimal Post-PCI QFR) trial was conceived to assess…

FIRE Trial: Complete or Culprit-Only PCI in Older Patients with Myocardial Infarction

Biscaglia et al. 2023

In this multicenter, randomized trial, elderly patients with myocardial infarction (MI) and multivessel coronary disease who were undergoing…

2-Year Outcomes of Angiographic Quantitative Flow Ratio-Guided Coronary Interventions

Song et al. 2023

The FAVOR III China trial, a multicenter, randomized, sham-controlled study, demonstrated the superior 1-year clinical outcomes of quantitative flow ratio (QFR)-based lesion…

Improved non-culprit stenosis assessment with ST-segment elevation myocardial infarction using Quantitative Flow Ratio.

Published in: 2023

Lin Wang, Alejandro Travieso, Nina van der Hoeven, Maarten A.H. van Leeuwen, Gladys Janssens, Hernán Mejía-Rentería, Adrián Jerónimo, Nieves Gonzalo, Robin Nijveldt, Niels van Royen, and Javier Escaned

Quantitative flow ratio and cardiovascular risk: paralleling the FFR ischaemic continuum

Published in: 2023

Morton J. Kern

Long-term prognostic value of quantitative-flow-ratio-concordant revascularization in stable coronary artery disease

Published in: 2023

Carlos Cortés, Pablo M Fernández-Corredoira, Lili Liu, Ramón López-Palop, Fernando Rivero, Octavio Jiménez, Alfonso Freites, Luis R Goncalves-Ramirez, Carlos Minguito, Ricardo Concepción, Ainhoa Pérez, David Del Val, Gunnar Leithod, Jonas Oberhuber-Kurth, Ignacio J Amat-Santos, José A Diarte, J Alberto San Román, Maria Rosario Ortas Nadal, Juan Luis Gutiérrez-Chico

Angiography-derived functional assessment of left main coronary stenoses

Published in: 2023

Sonoka Yuasa, Francesco Maria Lauri, Hernan Mejia-Renteria, Catherine Liontou, Hyun-Jong Lee, Toru Tanigaki, Masafumi Nakayama, Takayuki Warisawa, Takashi Uchiyama, Hitoshi Matsuo, Justin E Davies, Takao Sato, Javier Escaned

Impact of alirocumab on plaque regression and haemodynamics of non-culprit arteries in patients with acute myocardial infarction: a prespecified substudy of the PACMAN-AMI trial.

Published in: 2023

Sarah Bär, Raminta Kavaliauskaite, Tatsuhiko Otsuka, Yasushi Ueki, Jonas D. Häner, George C. M. Siontis, Stefan Stortecky, Hiroki Shibutani, Fabrice Temperli, Christoph Kaiser, Juan F. Iglesias, Robert Jan van Geuns, Joost Daemen, David Spirk, Thomas Engstrøm, Irene Lang, Stephan Windecker, Konstantinos C. Koskinas, Sylvain Losdat, Lorenz Räber

Quantitative flow ratio as a continuous predictor of myocardial infarction

Published in: 2023

Changdong Guan, MSc; Nils P. Johnson, MD; Rui Zhang, MD; Lihua Xie, MSc; Miao Chu, PhD; Yanyan Zhao, MSc; Zheng Qiao, MD; Sheng Yuan, MD; Zhongwei Sun, MSc; Kefei Dou, MD; Shengxian Tu, PhD; Lei Song, MD; Shubin Qiao, MD; Bo Xu, MBBS

Coronary angiography upgraded by imaging post-processing: present and future directions

Published in: 2023

Benoit Caullery, Laurent Riou, Gilles Barone-Rochette

Non-invasive angiographic-based fractional flow reserve: technical development, clinical implications, and future perspectives

Published in: 2023

Joyce Peper, Michiel L. Bots, Tim Leiner & Martin J. Swaans

Anonymous comparison of various angiography-derived fractional flow reserve software with pressure-derived physiological assessment

Published in: 2023

Kai Ninomiya, Patrick W. Serruys, Nozomi Kotoku, Jinying Zhou, Shigetaka Kageyama, Shinichiro Masuda, Pruthvi C. Revaiah, Bo Wang, Xingqiang He, Tsung-Ying Tsai, Momoko Kageyama, Emelyne Sevestre, Faisal Sharif, Scot Garg, Takashi Akasaka, Javier Escaned, Manesh R. Patel, Yoshinobu Onuma