FFR pressure wire comparative study: piezoresistive versus optical sensor

Cottens, Daan; Maeremans, Joren; Vrolix, Mathias; Lierde, Johan Van; Dens, Jo; Ferdinande, Bert

doi:10.1080/00015385.2021.1939510

Cited by 4 publications

(6 citation statements)

References 10 publications

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“…Previous studies of the relationship between IMR and MVO have shown that the IMR is higher in patients with STEMI and MVO ( 14 – 16 ). However, IMR is typically measured using a thermodilution wire with a sensor near its tip, which has less torquability in comparison with workhorse wires, leading to technical difficulty and increased cost ( 17 ). Furthermore, IMR requires pharmacological induction of hyperemia, which may be uncomfortable for patients and has a risk of morbidity from arrhythmia.…”

Section: Discussionmentioning

confidence: 99%

Ability of the coronary angiography-derived index of microcirculatory resistance to predict microvascular obstruction in patients with ST-segment elevation

Wen,

Wang,

Zheng

et al. 2024

Front. Cardiovasc. Med.

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BackgroundThe coronary angiography-derived index of microvascular resistance (caIMR) correlates well with the index of microcirculatory resistance (IMR), which predicts microvascular obstruction (MVO). However, the relationship between caIMR and MVO remains unclear.AimTo evaluate the predictive ability of caIMR of MVO after ST-segment elevation myocardial infarction (STEMI).MethodsCaIMR was calculated using computational flow and pressure simulation in patients with STEMI in whom MVO status had been assessed by cardiac magnetic resonance (CMR) after successful primary percutaneous intervention at Peking University First Hospital between December 2016 and August 2019. The clinical, biochemical, echocardiographic, and CMR characteristics were assessed according to MVO status. The predictive value of the clinical parameters and caIMR was evaluated.ResultsFifty-three eligible patients were divided into an MVO group (n = 32) and a no-MVO group (n = 21). The caIMR tended to be higher in the MVO group (41.6 U vs. 30.1 U; p = 0.136). CaIMR and peak cardiac troponin-I (cTNI) were independent predictors of MVO (per 1-U increment in caIMR: odds ratio [OR] 1.044, 95% confidence interval [CI] 1.004–1.086, p = 0.030; per 1 ng/L increase in peak cTNI: OR 1.018, 95% CI 1.003–1.033, p = 0.022). In receiver-operating characteristic curve analysis, when a cut-off value of 45.17 U was used, caIMR had some ability to predict MVO (area under the curve 0.622, 95% CI 0.478–0.752, p = 0.127).ConclusionsCaIMR and peak cTNI were independent predictors of short-term MVO in patients with STEMI who had undergone successful primary percutaneous coronary intervention and may help to identify those at high risk of MVO.

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Section: Discussionmentioning

confidence: 99%

Ability of the coronary angiography-derived index of microcirculatory resistance to predict microvascular obstruction in patients with ST-segment elevation

Wen,

Wang,

Zheng

et al. 2024

Front. Cardiovasc. Med.

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“…These systems have been well validated, with a reduction in pressure drift reported with the optical method[ 30 , 31 ]. Moreover, the latest versions of optical pressure guidewires enable its use as a workhorse guidewire for PCI by disconnecting and reconnecting the system.…”

Section: Fractional Flow Reservementioning

confidence: 99%

“…Several intracoronary pressure systems are currently available on the market: WaveWire™ (Philips Inc, Eindhoven, the Netherlands), COMET™ (Boston Scientific, Marlborough, MA, USA), PressureWire™ (St. Jude/Abbott, St. Paul, MN, United States), NAVVUS RXi ® (ACIST Medical Systems, Inc, Eden Prairie, MN), TruePhysio™ (Insight Lifetech) and OptoWire Deux (Opsens medical, Quebec, Canada) with fewer drift[ 31 ]. The COMET trial comparing the COMET™ and the PressureWire™ found similar results in terms of safety and performance[ 34 ].…”

Section: Fractional Flow Reservementioning

confidence: 99%

Fractional flow reserve and non-hyperemic indices: Essential tools for percutaneous coronary interventions

Boutaleb¹,

Ghafari²,

Carlier³

2023

World J Clin Cases

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Hemodynamical evaluation of a coronary artery lesion is an important diagnostic step to assess its functional impact. Fractional flow reserve (FFR) received a class IA recommendation from the European Society of Cardiology for the assessment of angiographically moderate stenosis. FFR evaluation of coronary artery disease offers improvement of the therapeutic strategy, deferring unnecessary procedures for lesions with a FFR > 0.8, improving patients' management and clinical outcome. Post intervention, an optimal FFR > 0.9 post stenting should be reached and > 0.8 post drug eluting balloons. Non-hyperemic pressure ratio measurements have been validated in previous studies with a common threshold of 0.89. They might overestimate the hemodynamic significance of some lesions but remain useful whenever hyperemic agents are contraindicated. FFR remains the gold standard reference for invasive assessment of ischemia. We illustrate this review with two cases introducing the possibility to estimate also non-invasively FFR from reconstructed 3-D angiograms by quantitative flow ratio. We conclude introducing a hybrid approach to intermediate lesions (DFR 0.85-0.95) potentially maximizing clinical decision from all measurements.

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“…However, if the gradient exceeds 2-3 mmHg, it is considered a significant drift 3,5 . In this case, repeated pressure equalization and function testing should be performed to obtain an accurate measurement.The prevalence of significant drift ranges from 7.4 to 73% for piezoelectric sensors 4,[6][7][8][9] . This large variation may be due to the differences in vendor pressure wires, the definitions of significant drifts, and operator-dependent errors.…”

mentioning

confidence: 99%

“…The prevalence of significant drift ranges from 7.4 to 73% for piezoelectric sensors 4,[6][7][8][9] . This large variation may be due to the differences in vendor pressure wires, the definitions of significant drifts, and operator-dependent errors.…”

mentioning

confidence: 99%

Effect of prolonged pressure equalization on final drifting during pressure wire studies

Jong,

Lu,

Lin

et al. 2024

Sci Rep

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Pressure drifting is a troublesome error in invasive coronary function tests. This study aimed to evaluate the relationship between prolonged and short-time pressure equalizations in pressure drifting. Pressure drifting was defined as the pressure gradient between the mean pressure of the distal wire sensor (Pd) and aortic pressure (Pa) when the wire was withdrawn to the tip of the guiding catheter. Significant drifts 1 and 2 were defined as the absolute values of pressure gradients > 2 and > 3 mmHg, respectively. A logistic regression model was used to evaluate the associations between prolonged pressure equalization and each pressure drifting. The prolonged pressure equalization strategy was associated with a lower incidence of drift 1 than the short-time pressure equalization strategy (6.84% vs. 16.92%, p < 0.05). However, no statistical differences were found in the incidence of drift 2 between the prolonged and short-time pressure equalization strategies (4.27% vs. 7.69%, p = 0.34). In the multivariable regression model, only the prolonged pressure equalization strategy predicted a lower incidence of pressure drift 1. In conclusion, the prolonged pressure equalization strategy was associated with a lower incidence of significant pressure drifting with more stringent thresholds than the short-time pressure equalization strategy.

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FFR pressure wire comparative study: piezoresistive versus optical sensor

Cited by 4 publications

References 10 publications

Ability of the coronary angiography-derived index of microcirculatory resistance to predict microvascular obstruction in patients with ST-segment elevation

Ability of the coronary angiography-derived index of microcirculatory resistance to predict microvascular obstruction in patients with ST-segment elevation

Fractional flow reserve and non-hyperemic indices: Essential tools for percutaneous coronary interventions

Effect of prolonged pressure equalization on final drifting during pressure wire studies

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