Diletti Roberto, Price Matthew J
Thoraxcenter, Erasmus University Rotterdam, the Netherlands.
Director, Cardiac Catheterization Laboratory, Scripps Clinic La Jolla, California, USA.
Interv Cardiol. 2017 Sep;12(Suppl 2):2-8. doi: 10.15420/icr.2017:12:2.S1.
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 FFRStent 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.
血流储备分数(FFR)是冠状动脉病变功能血流动力学评估的主要方法,指导经皮冠状动脉介入治疗(PCI)的决策。RXi®快速交换FFR系统,配备超薄单轨压力微导管(Navvus™),有可能简化PCI手术。ACIST医疗系统公司赞助的两项评估该微导管系统临床效用的研究数据在2017年5月16日至19日于巴黎举行的欧洲心血管介入治疗大会(EuroPCR)上公布。鹿特丹心脏病医院FFR支架评估(FFR-SEARCH)注册研究的早期数据表明,PCI术后,即使血管造影显示支架置入良好,近一半患者的FFR值仍低于0.90。该注册研究值得注意的是纳入了高比例的不稳定患者。基于导管的FFR测量的询问和标准技术评估(ACIST-FFR)研究表明,与传统压力导丝相比,该微导管系统测得的FFR值略低,两者差异的一个独立预测因素是Navvus微导管测量的病变生理严重程度,这意味着对于大多数测量而言,这种差异的临床影响微乎其微。这些发现进一步支持了微导管FFR系统,促使人们进一步研究优化手术流程。