Optowire for measuring fractional flow reserve

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.