Multi-vessel Disease

Ensure cost-efficiency in your Multi-vessel Disease cases

• Multi-vessels coronary artery disease (CAD) is a disease stage in which at least two or three of the epicardial coronary arteries is involved with atherosclerosis of significant severity
• The goal in the treatment of multi-vessel disease is to reduce angina and heart failure symptoms
• The FAME study demonstrated that routine measurement of FFR (Fractional Flow Reserve) during DES-stenting in patients with multi-vessel disease is superior to current angiography guided treatment and improves outcome of PCI significantly

• A strong growing body of clinical evidence supports FFR in increasingly more diverse patient populations and lesion subsets.
• Courage Trial showed that non-discriminatory stenting without regard for ischemia does not improve outcomes.
• Defer Trial showed that deferring patients with FFR ≥ 0.75  improved outcomes.
• FAME I study demonstrated that FFR-guided stenting (FFR < 0.8) vs. only angio-guided stenting significantly improved outcomes.
• FAME II study illustrated that PCI was superior to medical therapy with FFR < 0.8.
• Both FAME I and II stated that FFR was economical compared to other standards of care and lowered costs within 1 year compared to angiography alone.

FFR-guided procedures improved outcomes over angio-guided procedures.

• FAME I evaluated angio-guided PCI vs. FFR-guided PCI.
  • Lesions identified by angio requiring PCI randomized into two groups:  Angio-guided vs. FFR-guided.
  • FFR < 0.80 was used as the cutoff.
• The FFR group performed significantly better in MACE-free survival 30–360 days.
• The FFR group was statistically significant in Death/MI and MACE but improved in all metrics vs. the angio-guided group.

FFR-guided procedures improved outcomes over angio-guided procedures.

Absolute difference in MACE-free survival

FFR-guided procedures improved outcomes over angio-guided procedures.

1-year Outcomes

Deferring ischemic lesions (FFR < 0.8) lead to worse outcomes.

• FAME II randomized patients with FFR < 0.8 to PCI + MT* or MT compared to patients with FFR > 0.8 who received MT.
  • The goal of the study was to assess if MT alone was superior in ischemic lesions.
  • The trial was stopped early due to the statistically significant poor performance of the MT group.
• 83% Relative risk reduction in urgent revascularization in FFR PCI+MT group.