scholarly journals Fractional flow reserve derived from microcatheters versus standard pressure wires: a stenosis-level meta-analysis

Open Heart ◽  
2019 ◽  
Vol 6 (1) ◽  
pp. e000971 ◽  
Author(s):  
Henry Seligman ◽  
Matthew J Shun-Shin ◽  
Anushkumar Vasireddy ◽  
Christopher Cook ◽  
Yousif Y Ahmad ◽  
...  
Keyword(s):  
Fractional Flow Reserve ◽  
Meta Analysis ◽  
Medical Systems ◽  
Fractional Flow ◽  
Device Failure ◽  
Flow Reserve ◽  
Small Device ◽  
Standard Pressure ◽  
The Difference ◽  
Eden Prairie

AimsTo determine the agreement between sensor-tipped microcatheter (MC) and pressure wire (PW)-derived fractional flow reserve (FFR).Methods and resultsStudies comparing FFR obtained from MC (FFRMC, Navvus Microcatheter System, ACIST Medical Systems, Eden Prairie, Minnesota, USA) versus standard PW (FFRPW) were identified, and a meta-analysis of numerical and categorical agreement was performed. The relative levels of drift and device failure of MC and PW systems from each study were assessed. Six studies with 440 lesions (413 patients) were included. The mean overall bias between FFRMC and FFRPW was −0.029 (FFRMC lower). Bias and variance were greater for lesions with lower FFRPW (p<0.001). Using a cut-off of 0.80, 18 % of lesions were reclassified by FFRMC versus FFRPW (with 15 % being false positives). The difference in reported drift between FFRPW and FFRMC was small. Device failure was more common with MC than PW (7.1% vs 2%).ConclusionFFRMC systematically overestimates lesion severity, with increased bias in more severe lesions. Using FFRMC changes revascularisation guidance in approximately one out of every five cases. PW drift was similar between systems. Device failure was higher with MC.

Next Generation FFR Microcatheter Technology

2017 ◽  
Vol 12 (02) ◽  
pp. 2
Author(s):  
Katrina Mountfort ◽  
Keyword(s):  
Fractional Flow Reserve ◽  
Clinical Utility ◽  
Independent Predictor ◽  
Medical Systems ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Pressure Wire ◽  
Percutaneous Coronary ◽  
The Difference ◽  
Standard Techniques

Fractional flow reserve (FFR) is the mainstay of functional haemodynamic assessment of coronary artery lesions, guiding decisions in percutaneous coronary interventions (PCI). The RXi® rapid exchange FFR system, featuring an ultrathin monorail pressure microcatheter (Navvus™) has the potential to simplify PCI procedures. Data from two studies sponsored by ACIST Medical Systems evaluating the clinical utility of the microcatheter system were presented at EuroPCR, which took place over 16–19 May 2017 in Paris. Early data from the FFR-Stent Evaluated at Rotterdam Cardiology Hospital (FFR-SEARCH) registry have indicated that post-PCI, almost half of patients have FFR values below 0.90 even when stent placement appears fine on angiography. This registry is noteworthy for including a high proportion of unstable patients. The Assessment of Catheter-based Interrogation and Standard Techniques for Fractional Flow Reserve measurement (ACIST-FFR) study has shown that the microcatheter system provides a modestly lower FFR value compared with the traditional pressure wire, and an independent predictor of a difference between the two is the physiological severity of the lesion as measured by the Navvus microcatheter, meaning that the clinical impact of the difference is minimal for most measurements. These findings add to the growing body of evidence in support of the microcatheter FFR system and have prompted further research into optimising procedures.

scholarly journals Fractional flow reserve versus angiography for guiding percutaneous coronary intervention: a meta-analysis

Heart ◽  
2015 ◽  
Vol 101 (6) ◽  
pp. 455-462 ◽  
Author(s):  
Dongfeng Zhang ◽  
Shuzheng Lv ◽  
Xiantao Song ◽  
Fei Yuan ◽  
Feng Xu ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Fractional Flow Reserve ◽  
Meta Analysis ◽  
Coronary Intervention ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Percutaneous Coronary

scholarly journals Meta-Analysis of Diagnostic Performance of Contrast-Fractional Flow Reserve versus Quantitative Flow Ratio for Functional Assessment of Coronary Stenoses

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Ruitao Zhang ◽  
Jianwei Zhang ◽  
Lijun Guo
Keyword(s):  
Sensitivity And Specificity ◽  
Fractional Flow Reserve ◽  
Coronary Stenosis ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Flow Ratio ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow

Background. Use of the fractional flow reserve (FFR) technique is recommended to evaluate coronary stenosis severity and guide revascularization. However, its high cost, time to administer, and the side effects of adenosine reduce its clinical utility. Two novel adenosine-free indices, contrast-FFR (cFFR) and quantitative flow ratio (QFR), can simplify the functional evaluation of coronary stenosis. This study aimed to analyze the diagnostic performance of cFFR and QFR using FFR as a reference index. Methods. We conducted a systematic review and meta-analysis of observational studies in which cFFR or QFR was compared to FFR. A bivariate model was applied to pool diagnostic parameters. Cochran’s Q test and the I2 index were used to assess heterogeneity and identify the potential source of heterogeneity by metaregression and sensitivity analysis. Results. Overall, 2220 and 3000 coronary lesions from 20 studies were evaluated by cFFR and QFR, respectively. The pooled sensitivity and specificity were 0.87 (95% CI: 0.81, 0.91) and 0.92 (95% CI: 0.88, 0.94) for cFFR and 0.87 (95% CI: 0.82, 0.91) and 0.91 (95% CI: 0.87, 0.93) for QFR, respectively. No statistical significance of sensitivity and specificity for cFFR and QFR were observed in the bivariate analysis (P=0.8406 and 0.4397, resp.). The area under summary receiver-operating curve of cFFR and QFR was 0.95 (95% CI: 0.93, 0.97) for cFFR and 0.95 (95% CI: 0.93, 0.97). Conclusion. Both cFFR and QFR have good diagnostic performance in detecting functional severity of coronary arteries and showed similar diagnostic parameters.

Comparison of intracoronary versus intravenous adenosine‐induced maximal hyperemia for fractional flow reserve measurement: A systematic review and meta‐analysis

2019 ◽  
Vol 94 (5) ◽  
pp. 714-721 ◽  
Author(s):  
Mohamed Abo‐Aly ◽  
Georges Lolay ◽  
Christopher Adams ◽  
Ahmed Elsharawy Ahmed ◽  
Ahmed Abdel‐Latif ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fractional Flow Reserve ◽  
Meta Analysis ◽  
Fractional Flow ◽  
Flow Reserve

scholarly journals TCT-299 Adenosine Versus Regadenoson In Assessing Fractional Flow Reserve, A Meta Analysis

2015 ◽  
Vol 66 (15) ◽  
pp. B118-B119
Author(s):  
Muhammad S. Azzouz ◽  
Alok Saurav ◽  
Mohsin Salih ◽  
Toufik Mahfood Haddad ◽  
Mohamed Ayan ◽  
...  
Keyword(s):  
Fractional Flow Reserve ◽  
Meta Analysis ◽  
Fractional Flow ◽  
Flow Reserve
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