包括的機能評価によって、
より患者さんに寄り添う診断を

アボットはトータルフィジオロジーを
支援します

包括的機能評価によって、<br>より患者さんに寄り添う診断を

生理学的指標を用いた評価が必要

血管造影による評価は、解剖学的な狭窄度の評価に限られており、血行動態を反映した生理学的な虚血の評価はできません。また、可視化の限界により、冠微小循環障害(CMD)の診断も十分にはできません1

これが、学会のオピニオンリーダーやインターベンショニストの多くの方々が日常臨床において生理学的評価を採用/推奨する理由です。包括的な生理学的評価により、インターベンショニストは以下のために包括的な生理学的評価を行います。

  • 血管造影だけでは不十分な機能的診断
  • 心外膜病変の至適診療2.3
  • より良い患者管理を実現するための冠微小循環障害の診断4

PressureWire™ X ガイドワイヤーは、心外膜疾患と冠微小循環障害の両方を評価する唯一のワイヤレスプレッシャーワイヤーです5.6

生理学的指標の定義

心外膜疾患と冠微小循環障害の客観的診断

PressureWire™ Xを用いてFFR、RFRおよびCFR、IMRを測定する方法を見る

PressureWire X video 1
PressureWire X Guidewire video
PressureWire X video 1
PressureWire X Guidewire video

冠動脈全体の評価

微小循環指標とカットオフ


Society Guidelines for Physiologic Indices

 心外膜狭窄の診断冠微小循環障害の診断
 FFRRFRIMRCFR
ガイドライン

ACC/SCAI (見る)

CPT code (見る)

ESC Guideline 2019 (下表参照)
カットオフ値
(Defer / Nomal)
> 0.807> 0.898≥ 2.04,*< 254,*
計算式Pd/Pa全心周期におけるPd/Paの最小値最大充血時流量/安静時流量Pd/最大充血時流量
最大充血誘発不要


*IMR and CFR cutoffs in population of ischemia with no obstructive coronary artery disease (INOCA) patients, CorMicA trial1.

各指標の測定の詳細については、以下をご覧ください。


PressureWire™ Xガイドワイヤー:包括的機能評価をサポートする世界で唯一のワイヤレスプレッシャーガイドワイヤー6

圧センサーと温度センサーを備えたPressureWire™ X Guidewireは、冠動脈全体における包括的機能評価をサポートします5.6

  • 圧センサーを用いて、FFR、安静時Pd / Pa、およびRFRを測定します
  • 温度センサーから得られる温度情報を用いた熱希釈法でCFRおよびIMRを測定します

PressureWire™ X Guidewireは、慢性冠症候群(CCS)および急性冠症候群(ACS)症例の両方で臨床的に広く活用されています10-12

PressureWire Nearly 20 years of evidence


心外膜血管に対して、生理学的指標を用いて評価することにより、血管造影検査よりも多くの情報が得られるため、狭窄の重症度が層別化でき、インターベンションの可否判断にも役立ちます。

References

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  2. Pijls NH, de Bruyne B, Peels K, et al. Measurement of fractional flow reserve to assess the functional severity of coronary-artery stenoses. N Engl J Med. 1996;334(26):1703-1708.
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  5. Data on file at Abbott. Coroventis‡ CoroFlow‡ Cardiovascular System IFU.
  6. Volcano Corp. Verrata‡ guidewire and PrimeWire Prestige‡ Plus guidewire IFUs. Opsens Inc. OptoWire‡ guidewire and OptoWire‡ II guidewire IFUs. ACIST Medical Systems. Navvus‡ Microcatheter IFU. Boston Scientific Corporation. Comet‡ guidewire IFU. Abbott. PressureWire™ X guidewire IFU.
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