Summary

Summary

  • The technology described in this briefing is Optowire. It is used for measuring fractional flow reserve (FFR), to work out suitability for coronary artery stenting.

  • The innovative aspects are that it has an optical sensor and could minimise or prevent drift.

  • The intended place in therapy would be instead of existing pressure guide wires and other non-invasive devices used to measure FFR.

  • The main points from the evidence summarised in this briefing are from 3 non-comparative cohort studies including a total of 173 people (with 183 lesions) who had a clinical indication for percutaneous coronary intervention. The studies suggest that Optowire could be associated with minimal pressure drift when measuring FFR.

  • Key uncertainties around the evidence or technology include a lack of comparison with other invasive guide wires, uncertainty around the extent that FFR measurement improved because of reduced drift, and whether the evidence is generalisable to the NHS.

  • The cost of Optowire is £475 per unit and the reusable monitor is £3,000 (exclusive of VAT). The resource impact would be greater than standard care. This could be offset if the device improves FFR-guided decision making compared with similar pressure wires or non-invasive devices, and prevents stenosis misclassification and associated resources from unnecessary stenting of an artery. There is no published evidence to support these claims.