The FFR technology is not currently available in many medical centers, however. Its initial cost is $20,000, with a charge of about $600 for each use. "But its use will definitely increase if you look at these results, which I call impressive," Pijls said.
FFR is measured by inserting a pressure sensor mounted on a guidewire to the site of blockages in the arteries. FFR equipment is marketed by St. Jude Medical.
"This will provide impetus for some catheter laboratories to buy it, but we don't use it on a routine basis," said Dr. Stephen G. Ellis, director of the cardiac catheterization laboratory at the Cleveland Clinic and author of an editorial accompanying the report.
FFR measurements were used to guide stent implants in about 10 percent of cases at the Cleveland Clinic in the past year, Ellis said. "I doubt if we will be using it in more than 25 percent of cases," he said.
Cost is an issue, he said, since "economic times are hard for hospitals now. We don't have enough data on costs. What we need is a U.S.-based study of the cost involved. One would assume that because it reduces the number of second procedures, that would offset the roughly $600 cost per case."
The group that did the study "is now doing a more extended cost-benefit analysis," Pijls said.
The new report probably will not lead to a surge in American use of the FFR technology, according to Ellis, but its use is bound to widen. "This is not a revolution but a devolution," he said. "It is logical to treat only blockages that are physiologically significant."
There's much more on stents at the U.S. Food and Drug Administration.
SOURCES: Nico H. J. Pijls, M.D
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