http://www.theheart.org/web_slides/1337567.do A study on Vasodilator Free Measure of Fractional Flow Reserve (ADVISE) that investigate a new guidewire-based technology that analyzes pressure inside the vessel without the use of vasodilator agents such as adenosine.

1. ADVISE (Vasodilator Free Measure of
Fractional Flow Reserve)

2. ADVISE (Vasodilator Free Measure of
Fractional Flow Reserve)
J Davies (Imperial College London, UK)
TCT 2011
• Background:
Narrowing of coronary arteries interferes with blood flow and can cause
chest pain
Cardiologists sometimes quantify the extent of the narrowing by measuring
the fractional flow reserve (FFR)—the ratio of the pressure in the aorta to
the pressure downstream of the narrowing under conditions of maximal flow
• This study investigated a new guidewire-based technology that analyzes
pressure inside the vessel without the use of vasodilator agents such as
adenosine
This would simplify assessment and improve cardiologists’ ability to advise
patients on whether or not stent treatment would help their symptoms

3. ADVISE: Results
• The stability and magnitude of resistance measured during the resting wave-free
period is similar to the mean resistance achieved during adenosine hyperemia
• Intracoronary pressure was measured in 157 patients using iFR and FFR to
determine whether the two measurements were equivalent:
Analysis showed that iFR and FFR had a strong positive linear correlation
(r=0.90)
After adjustment for the variability in FFR, the iFR had a diagnostic accuracy
of 95%, positive predictive value of 97%, negative predictive value of 93%,
and sensitivity and specificity of 93% and 97%, respectively
iFR=instantaneous wave-free ratio

4. ADVISE: Commentary*
"It's exactly the same as FFR, there's no change, except we've managed to
stabilize our resistance using a mathematical algorithm rather than having to give a
drug to do the same thing . . . We know now from clinical trials that we do a lot
better if we don't make our judgments based on visual estimations of stenosis but
actually make an assessment based on the pressure drop across the whole length
of the artery."
- Dr Justin Davies
*All comments from ADVISE: New pressure measurement does not require adenosine, equals FFR
(http://www.theheart.org/article/1308707.do)

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