New data from prospective, global, multicenter, double-blind ADVISE II Registry presented during Late-Breaking Clinical Trials Session at 25th Annual TCT Scientific Symposium
  

SAN FRANCISCO, CA. -- Volcano Corporation, a leading developer and manufacturer of precision guided tools designed to enhance the diagnosis and treatment of coronary and peripheral vascular disease, today announced final results of ADVISE (Adenosine Vasodilator Independent Stenosis Evaluation) II, a prospective, double-blind, global, multicenter registry designed to investigate the diagnostic utility of the instant wave-Free Ratio™ (iFR®) Modality in assessing the severity of coronary stenosis. These final results replicate earlier findings and show that the hybrid iFR/FFR (Fractional Flow Reserve) approach correctly matched an FFR-only approach in 94.2 percent of coronary stenoses and successfully avoided use of adenosine in 65.1 percent of patients.

 

"I believe that the more physiology we can use to guide our patient therapy, the better," said Amir Lerman, M.D., co-principal investigator of ADVISE II and professor of medicine at the Mayo Clinic in Rochester, Minn. "Study data has suggested that FFR is associated with improved patient outcomes when used to help decide whether coronary vessels with stenosis require revascularization with stents or other treatment strategies. However, its use in clinical practice remains low, partly due to the requirement for adenosine administration. For this reason, I believe that the development and potential availability of iFR as an adenosine-free partner to FFR can be a significant development in the field of coronary physiology."

 

He added, "ADVISE II is the first prospective study with scientifically rigorous methodology to investigate the diagnostic utility of iFR in assessing coronary stenosis relevance in patients who represent a real-world population, providing evidence for the clinical value of the hybrid iFR/FFR approach. These results may help solve what I perceive as the underutilization of physiology in the cath lab. I believe that iFR is worth considering given that the ADVISE II data have shown a 94.2 percent match with FFR and removed the need for hyperemic drugs in 65.1 percent of cases."

 

The hybrid iFR/FFR approach is possible with the Volcano system because both measurements take place on the same pressure guide wire. In the hybrid workflow, iFR measurement is generally made in seconds after positioning the standard Volcano pressure guide wire.

 

"The goal of our iFR project from the beginning has been to remove barriers that prevent physicians from receiving the valuable information that physiology provides," said Joe Burnett, executive vice president and general manager of Volcano's Functional Management Business.  "In an environment where proper documentation and appropriate use criteria are helping to standardize treatment patterns around the world, angiography can be a rate-limiting factor because interpretation of angiographic images is inherently subjective. One physician may interpret a lesion as 75 percent blocked based on the angiographic image and another physician may review the same image and interpret the lesion as only 50 percent blocked. Tools such as iFR and FFR provide an objective measure. An FFR of 0.67 entered in the patient record will remain an FFR of 0.67, no matter who is reviewing that case down the road."

 

Burnett added, "ADVISE II is important because it shows that the retrospective performance of the iFR algorithm has now been confirmed in a controlled, prospective manner at 40 global centers with many different users.  This represents the final stage in our validation of iFR compared with other physiologic indices and gives us the confidence to move forward with a series of outcome studies where iFR will contribute to clinical decision making live in the cath lab , including the SYNTAX II trial and the DEFINE family of studies."

 

The iFR modality is currently approved for use in Japan, CE Marked, and is activated at more than 100 global sites. iFR is not commercially available in the United States; it is 510(k) pending.

 

Source: Volcano Corporation