Physiology Data Drives Successful, State-of-the-Art PCI

No two CAD patients are the same. SYNTAX II -- which now shows that more PCI patients can experience CABG-like outcomes out to five years -- emphasizes comprehensive physiology assessment before and after intervention. This functional patient information can impact treatment decisions and preparation, as well as provide clinical value post-procedure.

 

  • Physiological assessment was performed in 75.5% of the lesions. 
  • Out of 1559 lesions initially intended to be treated based on the angiographic findings, only 74.6% were found to be functionally significant. 
  • The use of coronary physiology deferred stenting in 25% of lesions.
  • FFR-guided stenting reduced rate of composite endpoint of death, nonfatal myocardial infarction, and repeat revascularization (13.2% vs 18.3%). 
  • Patients with ischemic lesions treated by PCI and MT, versus MT alone, had significantly lower rates of death, MI, and urgent revascularization.
 
FFR Provides
 

 
The DEFINE trial3 highlights the importance of physiology assessment after PCI. It demonstrates that patients whose baseline ischemia was more effectively treated had significantly improved outcomes and less recurrent angina at one-year post-procedure. Ischemia was measured immediately after intervention via Diastolic Hyperemia-Free Ratio (DFR).
 
 
 

 
  • Pd/Pa calculates the entire cardiac cycle at rest.
  • FFR calculates Pd/Pa during maximal hyperemia
  • DFR™ calculates a diastolic portion of the cardiac cycle at rest.

 

 

FFR

DFR

Pd/Pa

Type

Whole-cycle

Diastolic

Whole-cycle

Cutoff

0.80

0.89

0.91

No Hyperemic Agent Required

X

Inclusion in Appropriate Use Criteria*

Workhorse Pressure Guidewire Available

 
 

 
 

 

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