Coronary Artery Disease Clinical Trial
Official title:
Feasibility of On-line Computed Fractional Flow Reserve: The Wire-free Invasive Functional Imaging (WIFI) Study
Quantitative Flow Ratio (QFR) is a new method for evaluating the functional significance of coronary stenosis by calculation of the pressure in the vessel based on two angiographic projections. The purpose of the WIFI study is to evaluate feasibility of QFR when performed during coronary angiography and compare diagnostic accuracy to standard FFR.
Background:
Patients at high risk of having one or more coronary stenosis are evaluated routinely by
invasive coronary angiography (CAG) and often in combination with measurement of fractional
flow reserve (FFR) to assess the functional significance of identified stenosis. FFR is
assessed during CAG by advancing a wire with a pressure transducer towards the stenosis and
measure the ratio in pressure between the two sides of the stenosis during maximum blood flow
(hyperaemia) induced by adenosine infusion.
The solid evidence for FFR evaluation of coronary stenosis and the relative simplicity in
performing the measurements have supported adoption of an FFR based strategy in many centers
but the need for interrogating the stenosis by a pressure wire and the cost of the wire and
the drug inducing hyperaemia limits more widespread adoption.
Quantitative Flow Ratio is a novel method for evaluating the functional significance of
coronary stenosis by calculation of the pressure in the vessel based on two angiographic
projections.
The purpose of the WIFI study is to evaluate feasibility of QFR when performed during
coronary angiography and compare diagnostic accuracy to standard FFR.
Hypothesis:
QFR can be assessed during CAG for stenosis interrogated by FFR
Methods:
Proof-of-concept, prospective, observational, single arm study with inclusion of 100
patients. Clinical follow-up by telephone call after one year.
A stenosis with indication for FFR is identified and at least two angiographic projections
rotated at least 25 degrees around the target vessel are acquired during resting conditions.
QFR is calculated on-line using the Medis Suite application and simultaneously to the
operator performing the FFR measurement using I.V. adenosine. The QFR observer is blinded to
the FFR measurement.
QFR is reassessed off-line by internal observer and by an external core laboratory. Both
blinded to FFR results.
FFR is assessed in core laboratory by a different blinded observer
All data are entered and stored in a protected and logged trial management system
(TrialPartner).
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