Multicenter clinical evaluation of a piezoresistive‐MEMS‐sensor rapid‐exchange pressure microcatheter system for fractional flow reserve measurement
Open Access
- 5 May 2021
- journal article
- research article
- Published by Wiley in Catheterization and Cardiovascular Interventions
- Vol. 98 (2), E243-E253
- https://doi.org/10.1002/ccd.29678
Abstract
Objectives This multicenter, prospective clinical study investigates whether the microelectromechanical‐systems‐(MEMS)‐sensor pressure microcatheter (MEMS‐PMC) is comparable to a conventional pressure wire in fractional flow reserve (FFR) measurement. Background As a conventional tool for FFR measurement, pressure wires (PWs) still have some limitations such as suboptimal handling characteristics and unable to maintain the wire position during pullback assessment. Recently, a MEMS‐PMC compatible with any 0.014″ guidewire is developed. Compared with the existing optical‐sensor PMC, this MEMS‐PMC has smaller profiles at both the lesion crossing and sensor packaging areas. Methods Two hundred and forty‐two patients with visually 30–70% coronary stenosis were enrolled at four centers. FFR was measured first with the MEMS‐PMC, and then with the PW. The primary endpoint was the Bland–Altman mean bias between the MEMS‐PMC and PW FFR. Results From the 224‐patient per‐protocol data, quantitative coronary angiography showed 17.9% and 55.9% vessels had diameter < 2.5 mm and stenosis >50%, respectively. The two systems' mean bias was −0.01 with [−0.08, 0.06] 95% limits‐of‐agreement. Using PW FFR≤0.80 as cutoff, the MEMS‐PMC per‐vessel diagnostic accuracy was 93.4% [95% confidence interval: 89.4–96.3%]. The MEMS‐PMC's success rate was similar to that of PW (97.5 vs. 96.3%, p = .43) with no serious adverse event, and its clinically‐significant (>0.03) drift rate was 43% less (9.5 vs. 16.7%, p = .014). Conclusions Our study showed the MEMS‐PMC is safe to use and has a minimal bias equal to the resolution of current FFR systems. Given the MEMS‐PMC's high measurement accuracy and rapid‐exchange nature, it may become an attractive new tool facilitating routine coronary physiology assessment.Keywords
This publication has 31 references indexed in Scilit:
- Fractional flow reserve versus angiography for guidance of PCI in patients with multivessel coronary artery disease (FAME): 5-year follow-up of a randomised controlled trialThe Lancet, 2015
- Assessment of coronary fractional flow reserve using a monorail pressure catheter: the first-in-human ACCESS-NZ trialEuroIntervention, 2015
- Prognostic Value of Fractional Flow ReserveJournal of Invasive Cardiology, 2014
- Chasing NumbersJACC: Cardiovascular Interventions, 2013
- Fractional Flow Reserve–Guided RevascularizationJACC: Cardiovascular Interventions, 2013
- Coronary Pressure–Derived Fractional Flow Reserve MeasurementsCirculation: Cardiovascular Interventions, 2012
- Fractional Flow Reserve versus Angiography for Guiding Percutaneous Coronary InterventionThe New England Journal of Medicine, 2009
- Intracoronary and Intravenous Adenosine 5′-Triphosphate, Adenosine, Papaverine, and Contrast Medium to Assess Fractional Flow Reserve in HumansJournal of the American College of Cardiology, 2003
- Fractional Flow Reserve to Determine the Appropriateness of Angioplasty in Moderate Coronary StenosisJournal of the American College of Cardiology, 2001
- Practice and potential pitfalls of coronary pressure measurementCatheterization and Cardiovascular Interventions, 2000