Cavis Wirecath® pressure guide wire
Developed and manufactured in Scandinavia
Our goal when developing the Wirecath was to create a pressure guide wire that consistently delivers accurate measurements. Wirecath is the only pressure wire immune to hydrostatic pressure errors, a proven problem with all traditional pressurewires (1, 2, 3). At the same time it gives you unique torque control for easy navigation, even in the most complex anatomies.
Precision. Quite Simply.
Discover the revolutionary technology
No errors in measurements due to hydrostatic pressure or drift
All traditional sensor-tipped pressure wires are affected by a physical phenomenon causing hydrostatic pressure error (1, 2, 3). The measuring error varies from patient to patient, but the data variation can be significant.
With Wirecath®, the hemodynamic pressure measurements are performed through the fluid-filled interior of the wire, in combination with an external pressure transducer. This is why the Wirecath pressure guide wire is not prone to hydrostatic pressure errors (4, 5) delivering correct, precise measurements.
Moreover, drift is avoided by using the external pressure transducer.
Kawaguchi Y. et al. Impact of Hydrostatic Pressure Variations Caused by Height Differences in Supine and Prone Positions on Fractional Flow Reserve Values in the Coronary Circulation. J Interv Cardiol. 2019; 2019: 4532862
Härle T. et al. Effect of Coronary Anatomy and Hydrostatic Pressure on Intracoronary Indices of Stenosis Severity. JACC Cardiovasc Interv. 2017 Apr 24;10(8):764-773
Al-Janabi F. et al. Coronary artery height differences and their effect on fractional flow reserve. Cardiol J. 2019 Mar 26
Courtois M. et al. Anatomically and physiologically based reference level for measurement of intracardiac pressures. Circulation. 1995 Oct 1;92(7):1994-2000
Pijls NH. et al. Practice and potential pitfalls of coronary pressure measurement. Catheter Cardiovasc Interv. 2000 Jan;49(1):1-16.
Experience reliable wire performance in tortuous vessels
The torque is transmitted directly to the tip without interference from any inbuilt cables, optical fibers or sensors. The connection rotates freely to the external pressure transducer, to facilitate maximum control and torque response, also in the most complex anatomies. The shapeable and atraumatic soft tip is designed to protect the vessel, without compromising shape retention.
Accurately measure and diagnose
Wirecath® provides accurate and reproducible hemodynamic pressure measurements throughout the entire procedure. The connection of the wire to the transducer is easy to do. After reconnection, the signal is reliable. Pressure measurements remain reliable, also at elevated heart rates.
Cath lab compatibility and easy integration
No additional hardware is needed in your lab. Use the external pressure transducer, and the integrated FFR software of your system to measure physiological indices such as resting Pd/Pa, FFR, and do research in pressure-derived CFR.
Based on the CONTRAST study data with 627 analysable patients, (1, 3) and the RESOLVE study with 1593 analysable measurements (2), it was shown that Pd/Pa has an excellent correlation with iFR of r = 0.96 and r=0.97, respectively.
When iFR was measured in the same vessel twice, the same correlation of r = 0.96 between repeated measurements was shown (1), see figure below.
Based on the CONTRAST study data, using iFR ≤0.89 as a reference standard, the agreement with Pd/Pa and its best cut-off value were Pd/Pa ≤0.91 (3).
In the RESOLVE study the best cut-off to predict FFR ≤0.80 was iFR ≤0.90 and Pd/Pa ≤0.92 (2).
An outcome study showed equal outcome between different resting indices, including Pd/Pa (4).
ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2017 Appropriate Use Criteria for Coronary Revascularization in Patients With Stable Ischemic Heart Disease (5):
”Newer physiological measurements that do not require hyperemia measure […] during the whole cardiac cycle or the wave-free portion of the cycle […] have similar diagnostic concordance with FFR […]”
”Substitution of one of the newer physiological measurements for FFR may be considered provided the appropriate reference values are used”
Coronary auto-regulation explains why resting pressure indices, including Pd/Pa, can be used to detect the haemodynamic significance of coronary artery stenoses (6).
FFR, iFR, and Pd/Pa showed a similar performance when compared with PET imaging-derived blood flow (7).
Videos regarding the class effect among resting indices:
Johnson NP. et al. Continuum of Vasodilator Stress From Rest to Contrast Medium to Adenosine Hyperemia for Fractional Flow Reserve Assessment. JACC Cardiovasc Interv. 2016 Apr 25;9(8):757-767. (CONTRAST)
Jeremias A. et al. Multicenter core laboratory comparison of the instantaneous wave-free ratio and resting Pd/Pa with fractional flow reserve: the RESOLVE study. J Am Coll Cardiol. 2014 Apr 8;63(13):1253-1261.
Kobayashi Y. et al. Agreement of the Resting Distal to Aortic Coronary Pressure With the Instantaneous Wave-Free Ratio. J Am Coll Cardiol. 2017 Oct 24;70(17):2105-2113.
Lee JM. et al. Clinical Outcome of Lesions With Discordant Results Among Different Invasive Physiologic Indices - Resting Distal Coronary to Aortic Pressure Ratio, Resting Full-Cycle Ratio, Diastolic Pressure Ratio, Instantaneous Wave-Free Ratio, and Fractional Flow Reserve. Circ J. 2019 Oct 25;83(11):2210-2221.
Patel MR. et al. ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2017 Appropriate Use Criteria for Coronary Revascularization in Patients With Stable Ischemic Heart Disease: A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2017 May 2;69(17):2212-2241.
Nijjer SS. et al. Coronary pressure and flow relationships in humans: phasic analysis of normal and pathological vessels and the implications for stenosis assessment: a report from the Iberian-Dutch-English (IDEAL) collaborators. Eur Heart J. 2016 Jul 7;37(26):2069-80.
de Waard GA. et al. Fractional flow reserve, instantaneous wave-free ratio, and resting Pd/Pa compared with [15O]H2O positron emission tomography myocardial perfusion imaging: a PACIFIC trial sub-study. Eur Heart J. 2018 Dec 7;39(46):4072-4081.