Workhorse-like FFR wire assesses complex case with 90° angle

• Female 76 years old with hypertension & diabetes mellitus
• Renal dysfunction (serum creatinine 2 mg/dl)
• Previous coronary angiography (5 years ago) for stable angina: not significant stenosis with indication to optimal medical therapy (not pictured)
• Recent admission to surgical department for liver resection (high risk surgery > 5%)
• Cardiovascular assessment pre surgery resulted in: functional capacity < 4 mets and chest pain during intense effort
• Indication to perform coronary angiography

Case Challenges

• Significant angulation and tortuosity: may be difficult to deliver FFR wire
• “Oculo-stenotic” assessment may determine PCI on both obtuse marginal (OM) and left anterior descending and therefore DAPT are needed

Coronary Angiography Performed

• Note: Access to first OM was difficult at a 90º angle. This was complicated by an additional stenosis immediately after the ostium
• Second obtuse marginal: no change from the previous examination
• LAD showed a 65% stenosis in the distal segment

COMET^TM FFR Pressure Guidewire Characteristics

• Asahi co-developed for true workhorse capabilities
• Free rotation while steering and reliable re-connection 
• Optical pressure sensor

• The COMET^TM FFR wire was delivered down the LAD and gives an FFR value of 0.83
• No stents placed

• COMET^TM FFR wire delivers down a highly tortuous vessel with 90º angle

• The need to have available new, modern FFR guide wires that allow the operator to analyse complex, tortuous vessels with angulation. 

• In this case FFR helped the operator avoid unnecessary PCI and DAPT treatment thereby keeping the surgical option open if deemed necessary in the future.