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Pressure Guidewire Indicated for Coronary Fractional Flow Reserve Assessment: Structural Design, Deficiencies and
Wengang Liu1, Jun Shi2, Rong Shan2
1School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China.
Insights
Fractional flow reserve (FFR) pressure guidewires assess coronary artery disease severity. This review details their development, common issues like signal drift, and solutions for improved clinical use.
Area of Science:
- Cardiovascular Medicine
- Medical Devices
- Interventional Cardiology
Background:
- Coronary heart disease (CHD) is a major global cause of death, often due to myocardial ischemia from atherosclerotic plaques.
- Accurate assessment of myocardial ischemia severity is vital for guiding CHD treatment, including medication and interventions.
Purpose of the Study:
- To review the historical development of pressure guidewires used for Fractional Flow Reserve (FFR) assessment.
- To examine the structure of commonly used pressure guidewires.
- To highlight clinical issues and propose solutions for pressure guidewire use in FFR measurement.
Main Methods:
- Review of historical literature on pressure guidewire development.
- Examination of the general structure of two market-available pressure guidewires.
- Analysis of reported clinical issues encountered during FFR assessment using pressure guidewires.
Main Results:
- Pressure guidewires are essential for clinical FFR assessment, measuring coronary lesion severity.
- Common issues include signal drift, tip breakage, core wire fractures, and coating detachment.
- The article identifies and discusses practical solutions for these encountered problems.
Conclusions:
- Pressure guidewires are critical tools for guiding coronary revascularization by assessing myocardial ischemia severity.
- Understanding and addressing common clinical issues with pressure guidewires can improve procedural safety and efficacy.
- This review provides valuable insights for clinicians and manufacturers to optimize pressure guidewire technology and application.
Abstract:
Coronary heart disease (CHD) is one of the leading causes of mortality worldwide. It is primarily caused by myocardial ischemia and hypoxia resulting from atherosclerotic plaques in the coronary arteries, leading to symptoms such as angina. The severity of CHD determines the treatment approach, which may include medication or interventional therapy. Therefore, accurately assessing the severity of myocardial ischemia is crucial for effective CHD management. In recent years, fractional flow reserve (FFR), derived from the relationship between flow and pressure, has gained widespread recognition for providing valuable information to guide coronary revascularization. Pressure guidewires equipped with pressure sensors at their tips are the most commonly used tools for clinical FFR assessment. These wires measure vessel pressure to determine the severity of coronary lesions. However, during their use, issues such as signal drift, tip breakage, core wire fractures, and coating detachment may occur. This article reviews the historical development of pressure guidewires, examines the general structure of two commonly used pressure guidewires available in the market, highlights typical issues encountered during clinical use, and proposes corresponding solutions.
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