8 July 2011

NICE Consults on Device to Improve the Outcome of Heart Bypass Graft Surgery

The National Institute for Health and Clinical Excellence (NICE) today (8 July) opens its consultation on the use of a device that can help improve the outcome of a specific type of heart surgery. The draft medical technology guidance provisionally supports the use of VeriQ, a system that assesses blood flow through a graft during coronary artery bypass graft (CABG) surgery.

CABG surgery is performed to treat heart disease where the major arteries have become narrowed or blocked. A blood vessel is taken from another part of the patient's body and used to ‘bypass' the affected section of artery by attaching it above and below the blockage or narrowing. The new section of blood vessel is called a graft.

The VeriQ system benefits patients by helping clinicians to identify imperfections in the graft, such as the vessel becoming blocked, which can then be corrected during the same operation. This reduces the risk of patients suffering early graft failure, serious medical complications or even death. The VeriQ system uses ultrasound with specially designed external probes to measure the blood flow through the graft vessel during surgery. The device manufacturer claims that if the VeriQ system is used, the expected lower incidence of complications will reduce hospital stay for some patients, as well as cutting the number of repeat procedures.

This draft medical technology guidance was produced by the Medical Technologies Advisory Committee (MTAC), which is part of the Medical Technologies Evaluation Programme. This new programme will help enable new medical technologies, or innovative modifications to existing ones, to be used more quickly and consistently in the NHS across England. In particular, MTAC looks at whether a device offers benefits to the patient and NHS at a lower cost compared with similar products, or increased benefits for equal cost. The cost saving associated with using VeriQ is estimated to be £115 per patient.

Mirella Marlow, NICE Programme Directorfor Devices and Diagnostics, said: "The evidence provided enabled MTAC to make a supportive provisional recommendation on the VeriQ system for assessing graft flow during coronary artery bypass graft surgery. The system appears to offer potential benefits to both patients and the NHS, by improving the outcome of heart bypass graft surgery, reducing complications and reducing the length of hospital stays. We look forward to receiving comments on our provisional recommendations from health professionals, industry and patient groups to help inform the development of this guidance."

More information on the medical technology draft guidance consultation is available at http://guidance.nice.org.uk/MT/116 . The consultation closes on 4 August 2011.

Notes

About the guidance

1. The cost saving associated with use of VeriQ, compared against clinical assessment of coronary artery bypass grafts during surgery, is estimated to be £115 per patient, when the system is used routinely for assessing coronary artery bypass grafts during surgery. Approximately 22,500 isolated CABG surgeries are performed in the UK each year.

2. The VeriQ system is manufactured by MediStim ASA.

About the Medical Technologies Evaluation Programme

3. Established by NICE in 2009, the focus of this new area of work is specifically on the evaluation of innovative medical technologies, including devices and diagnostics. The types of products which might be included are medical devices that deliver treatment such as those implanted during surgical procedures, technologies that give greater independence to patients, and diagnostic devices or tests used to detect or monitor medical conditions. The independent Medical Technology Advisory Committee has two core remits: selecting medical technologies for evaluation by NICE guidance programmes and also developing medical technologies guidance itself. The guidance applies to the NHS in England, and is not mandatory.

More information is available at http://www.nice.org.uk/MT .

About NICE

4. The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance and standards on the promotion of good health and the prevention and treatment of ill health.

5. NICE produces guidance in three areas of health:

  • public health -guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
  • health technologies -guidance on the use of new and existing medicines, treatments, medical technologies (including devices and diagnostics) and procedures within the NHS
  • clinical practice -guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.

6. NICE produces standards for patient care:

  • quality standards- these reflect the very best in high quality patient care, to help healthcare practitioners and commissioners of care deliver excellent services
  • Quality and Outcomes Framework -NICE develops the clinical and health improvement indicators in the QOF, the Department of Health scheme which rewards GPs for how well they care for patients

7. NICE provides advice and support on putting NICE guidance and standards into practice through its implementation programme, and it collates and accredits high quality health guidance, research and information to help health professionals deliver the best patient care through NHS Evidence.