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FFR-SEARCH: Microcatheter-based poststenting FFR may predict outcomes after PCI
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The use of a microcatheter to perform factional flow reserve after stenting may help clinicians optimize PCI procedures and predict poststenting clinical outcomes, according to data presented at EuroPCR.
Roberto Diletti, MD, PhD, interventional cardiologist at Thoraxcenter of the Erasmus Medical Center in Rotterdam, the Netherlands, and colleagues conducted FFR-SEARCH, a prospective registry study of 1,000 patients (mean age, 65 years; 73% men) with 1,348 lesions who underwent successful PCI and had FFR measured with a microcatheter (Navvus, Acist Medical) after the procedure.
“An FFR below 0.9 could be relevant for events later on, especially for repeat revascularization and MACE,” Diletti told Cardiology Today’s Intervention. “You have in place the wire for the PCI, you just need this catheter to go down on the wire, and you can measure the FFR just after stenting.”
Results were available for 959 patients with 1,165 lesions; there were no complications related to the microcatheter.
Diletti and colleagues found 43.3% of lesions had FFR 0.9, 19.8% had FFR 0.85 an 7.7% had FFR 0.8, whereas 48% of patients had at least one lesion with FFR 0.9, 22% had at least one lesion with FFR 0.85 and 8.9% of patients had at least one lesion with FFR 0.8.
“That means a large part of the treatment could be optimized, so there are fewer events later on, if the value of 0.9 is still relevant for clinical outcomes,” Diletti said in an interview. “We could optimize the procedure if we performed poststenting FFR on a regular basis.”
At 30 days, the overall rate of MACE was 1.9%, and was 2.8% in patients with FFR 0.8, 2.6% in those in FFR 0.81 to 0.85, 2% in those with FFR 0.86 to 0.9, and 1.5% in those with FFR > 0.9 (P = .792), according to the researchers.
“We based our power calculations on 2-year clinical outcomes. We expect to see a difference much later,” Diletti told Cardiology Today’s Intervention. “At the moment, we are just seeing a numerical trend that ... is going in the direction we expect to see at 2 years.”
If poststenting FFR predicts clinical outcomes at 2 years, “we might be able to optimize our procedure based on FFR value, and we could probably have a great impact on clinical outcomes, especially in terms of repeat revascularization and overall MACE,” Diletti said. – by Erik Swain
Reference:
Diletti R, et al. PCI: Procedural techniques and clinical outcomes – Session comprising selected EuroPCR late-breaking clinical trial submissions. Presented at: EuroPCR; May 16-19, 2017; Paris.
Disclosure: Diletti reports no relevant financial disclosures.