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"Despite all the questions that surround percutaneous coronary interventions (PCI) today, there is an exciting evolution taking place in the form of more precise stenting decisions and guidance with physiology tools like Fractional Flow Reserve (FFR)," commented Joe Burnett, Executive Vice President and General Manager of the Functional Management Business Unit at Volcano. "Data from the DEFER, FAME and FAME II trials have repeatedly provided evidence that FFR is the best and most evidence-based diagnostic tool available to help properly diagnose a patient's vessel, or even a specific blockage. In the five years since FAME, it is increasingly uncommon that a physician makes a decision based on angiography alone, without some sort of functional assessment being performed. We believe that FFR is the most proven vessel-specific assessment available." "Physiology will continue to evolve," added Burnett. "Even though FFR is routinely used to decide if a patient needs treatment, daily practice often reverts back to the basic angiogram to select which lesions get treated and to confirm the treatment was successful. There is a tremendous amount of information physiology can provide that we have yet to unlock in daily practice. The Verrata wire and iFR modality are designed to continue that evolution to allow physicians to quickly and easily get valuable functional information throughout a stent procedure." The Verrata™ Pressure Guide Wire will be Volcano's fifth new pressure guide wire in the past five years. It embodies a new wire design and workflow designed to facilitate fast, simple connections and re-connections throughout a procedure. "The proposed workflow of the new wire is ideal because it would more closely mimic standard guidewire use in everyday practice," commented Bruce Samuels, MD of Cedars-Sinai Hospital in Los Angeles, CA. "The biggest difference between an everyday interventional wire and a pressure wire is the large, heavy connector that resides on the end. The design of the new Verrata wire would allow me to very quickly and easily disconnect and reconnect the wire with no interruption to my workflow. Re-connecting a pressure wire is now faster than re-connecting the indeflator for a stent delivery system, which would allow me to steer the Verrata wire just like a standard interventional wire with no connector, and simply reconnect any time I want to take a measurement. This is ideal for delivering devices like balloons and stents over the wire, and then making valuable physiologic measurements after each step. I can forsee the functional improvement that my therapy will have on the patient and not be forced to only trust the angiogram." Our new iFR® software modality was developed in concert with Imperial College London. Using the same pressure wire and equipment currently used for FFR, iFR® amplifies the patient's physiologic measurements during resting conditions before stressing the heart with a commonly used vasodilator drug, like Adenosine. "I continue to be amazed at how inaccurate the angiogram can be," commented Matthias Gotberg, Interventional Cardiologist, Department of Coronary Heart Disease, Skane University Hospital, Lund, Sweden. "Physiology uncovers very important functional information that simply disagrees with the angiogram and should not be ignored. By making this meaningful measurement in seconds, physicians can get physiologic answers, but in a workflow almost identical to how they perform angiographic PCI today. In essence, you can repeatedly double-check the angiogram with actual heart function and add very little time to your procedure. I have had access to the live software for more than three months now. Quite simply, today I am making functional measurements with iFR that before I would have left to angiography alone." "iFR and FFR look at the same lesion, but from two different viewpoints," said Justin Davies, MBBS, MRCP, PhD, of Imperial College London. "FFR will always be an important tool for us in the lab. It creates a 'worst-case-scenario' to rule out ischemia, and patients with a negative FFR test do very well clinically with medical therapy alone. At the same time, retrospective iFR core lab analysis in over 1,500 patients suggests that more than half of our patients could avoid the need for hyperemic drugs and still benefit from the proven value of these physiologic assessments. ADVISE II will be the very first prospective, multi-center independent study using the currently available Volcano/Imperial iFR algorithm to seek to confirm this hypothesis." Results from the first 300 ADVISE II patients will be presented at EuroPCR as part of the Hot Line late-breaking clinical trial session on Thursday, May 23rd at 10:09 AM in Room 351. Both the Verrata™ Pressure Wire and the iFR® software modality will be compatible with Volcano's multi-modality imaging systems including the latest CORE™ Integrated System which will also be on display at EuroPCR 2013. iFR® is currently active in more than 20 centers around the world. Hospitals in London, Rotterdam and Johannesburg will be transmitting live iFR® cases throughout this week at PCR. "These two new tools will make physiology more accessible and mainstream, and that is a good thing for hospitals and patients," continued Burnett. "The easier it is for a physician to double-check the angiogram, the better. Having both iFR and FFR on the same system, just one click away, only expands the options to do so. This is a very exciting time for Volcano's physiology program as we are executing our vision of a frontline interventional wire workflow that can quickly and easily provide functional information beyond angiography." About Volcano Corporation Forward-Looking Statements
Source: Volcano Corporation |
