Feature | November 01, 2013

Trial Examines Benefits of iFR vs. FFR to Determine Severity of Coronary Artery Disease

Results of the ADVISE II Trial Presented at TCT 2013

cath lab clinical trial study fraction flow reserve FFR
November 1, 2013 — A study supports the use of instantaneous wave-free ratio (iFR) to simplify assessment and determine the severity of coronary artery disease (CAD). ADVISE II findings were presented at the 25th annual Transcatheter Cardiovascular Therapeutics scientific symposium (TCT 2013).
 
ADVISE II enrolled 797 patients in a prospective, observational, non-randomized double blind global multi-center registry study with an adaptive design. The diagnostic performance of iFR was analyzed both as a dichotomous index and as part of a hybrid iFR/FFR strategy. iFR was used according to specific cutoffs (iFR zone, ? 0.85 and ? 0.94) with high positive and high negative predictive value for the detection of hemodynamically severe stenosis. FFR use was limited to the “adenosine zone” for iFR values between 0.86 and 0.93. The primary endpoint was the percentage of stenosis properly classified in terms of hemodynamic severity (FFR value ? 0.8). 
 
The final study population consisted of 690 stenoses and of these, 31 percent had an associated iFR value in the adenosine zone (0.86-0.93) while 69 percent had associated iFR values in the iFR zone. Within the iFR zone, the percentage of stenosis properly classified in terms of hemodynamic severity was 91.6 percent. Overall the hybrid iFR/FFR approach correctly classified 94.2 percent of coronary stenoses, without the need for adenosine administration in 65.1 percent of patients.
 
“The results of the ADVISE II study support the use of iFR to simplify physiological guidance of percutaneous coronary intervention,” said Javier Escaned, M.D, Ph.D., interventional cardiologist, Hospital Clinico San Carlos, Madrid, Spain, and lead investigator of the study.
 
“The promising results demonstrate the potential of boosting the benefits of ischemia-driven revascularization to a larger proportion of patients with coronary artery disease.”
 
For more information: www.crf.org

Related Content

Gore, DrySeal Flex Introducer Sheath, endovascular repair, EVAR
Technology | Vascular Access| August 30, 2016
W. L. Gore & Associates Inc. (Gore) announced the commercial availability of the Gore DrySeal Flex Introducer...
News | Cardiac Resynchronization Therapy Devices (CRT)| August 30, 2016
August 30, 2016 — Medtronic plc announced results from the...
Medtronic, Micra TPS pacemaker, transcatheter pacing system, global clinical trial, one-year results, ESC 2016
News | Pacemakers| August 29, 2016
August 29, 2016 — Medtronic plc announced new long-term results from the Medtronic Micra Transcatheter Pacing System
cardiac surgery, simulation training, University of Washington, case studies

Multiple repetitions of bypass grafts on a heart, using the Ramphal simulator. Courtesy of the University of Washington in Seattle.

News | Cardiovascular Surgery| August 25, 2016
August 25, 2016 — Simulation training fo
aortic dissection, family history, same age, clinical study, John A. Elefteriades, Annals of Thoracic Surgery
News | Structural Heart| August 25, 2016
People with a family member who had an aortic dissection — a spontaneous tear in one of the body’s main arteries —...
nanoparticles, blood clotting, internal bleeding, American Chemical Society study, Erin B. Lavik

Nanoparticles (green) help form clots in an injured liver. The researchers added color to the scanning electron microscopy image after it was taken. Image courtesy of Erin Lavik, Ph.D.

News | Hemostasis Management| August 24, 2016
August 24, 2016 — Whether severe trauma occurs on the battlefield or the highway, saving lives often comes down to...
Intact Vascular, TOBA clinical study, one-year results, Tack Endovascular System, Journal of Vascular Surgery
News | Peripheral Arterial Disease (PAD)| August 24, 2016
Intact Vascular Inc. announced that the one-year results from its Tack Optimized Balloon Angioplasty (TOBA) clinical...
Technavio report, renal denervation devices, 2015
News | Renal Denervation| August 23, 2016
August 23, 2016 — Technavio analysts forecast the global...
News | Heart Failure| August 23, 2016
August 23, 2016 — A new study of more than 13,000 people has found that so-called morbid obesity appears to stand alo
Jason Burdick, injectable hydrogels, heart failure, heart attack, American Chemical Society

Compared to other types of hydrogels being developed (left), a new hydrogel (right) can form crosslinks after injection into the heart, making the material stiffer and longer-lasting. Image courtesy of American Chemical Society.

News | Heart Failure| August 23, 2016
August 23, 2016 — During a heart attack, clots or narrowed arteries block blood flow, harming or killing cells within
Overlay Init