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Sensor-equipped Ultrathin Pressure Microcatheter Versus Pressure Wire for FFR Measurement

Completed
Conditions
Myocardial Ischemia
Coronary Artery Disease
Coronary Disease
Interventions
Device: TruePhysioTM Microcatheter
Device: Pressure Wire
Registration Number
NCT03541577
Lead Sponsor
Insight Lifetech Co., Ltd.
Brief Summary

TruePhysioTM Sensor-equipped Ultrathin Pressure Microcatheter (referred to as TruePhysioTM Microcatheter below) is a novel device for evaluating the functional significance of coronary stenosis. This study will compare the differences, if any, between the coronary fractional flow reserve (FFR) measured by the TruePhysioTM Microcatheter and the Pressure Wire.

Detailed Description

Many studies have reported that FFR-guided coronary revascularization leads to improved long-term clinical outcomes and reduced costs compared with angiography-guided coronary revascularization alone. Current guidelines emphasize the measurement of FFR as the standard of reference when determining the functional significance of coronary artery stenosis in stable patients when evidence of ischemia is not available (class IA indication). But FFR is still underutilized in clinical practice. One of the reasons may be the difficulty in manipulating the Pressure Wire.

TruePhysioTM Microcatheter is a novel device for evaluating the functional significance of coronary stenosis, which may simplify FFR measurements by allowing the use of standard guidewires best suited to negotiating the patients' anatomy. This study is a prospective, open label, multi-center study with the purpose of comparing the differences, if any, between FFR measured by the TruePhysioTM Microcatheter and Pressure Wire. The secondary purpose is to analyze the correlation between FFR measured by the TruePhysioTM Microcatheter and Pressure Wire. A total of 239 patients will be recruited at 4 centers in China.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
242
Inclusion Criteria
  • Age: 18-75 years old
  • Subjects with coronary artery disease
  • Able to understand and provide signed consent

Angiographic Inclusion Criteria:

  • Subject has an intermediate stenosis in a native coronary vessel
  • The target stenosis has a reference diameter ≥2.50 mm by visual assessment.
Exclusion Criteria

General Exclusion Criteria:

  • Acute ST-elevation or non-ST-elevation myocardial infarction
  • Severe heart failure (NYHA≥IV)
  • Left ventricular ejection fraction <30%
  • Allergy to adenosine triphosphate (ATP)
  • Contraindications for percutaneous coronary intervention (PCI)

Angiographic Exclusion Criteria:

  • Target vessel has angiographically visible or suspected thrombus
  • Angiographic evidence of a dissection
  • Excessive tortuosity or calcification stenosis, left main stenosis, serial stenosis

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
ParticipantsTruePhysioTM MicrocatheterSubjects who meet the inclusion criteria and do not meet the exclusion criteria and undergo FFR measurement with the TruePhysioTM Microcatheter and the Pressure Wire
ParticipantsPressure WireSubjects who meet the inclusion criteria and do not meet the exclusion criteria and undergo FFR measurement with the TruePhysioTM Microcatheter and the Pressure Wire
Primary Outcome Measures
NameTimeMethod
FFR MeasurementsDuration of FFR measurement

Comparisons between the FFR measured by the TruePhysioTM Microcatheter and the Pressure Wire (PW), including bias, as assessed by Bland-Altman analysis.

Secondary Outcome Measures
NameTimeMethod
Pearson analysisDuration of FFR measurement

Pearson analysis of paired FFR measurements by TruePhysioTM Microcatheter and PW.

Intercept of Passing-Bablok fitDuration of FFR measurement

Intercept of Passing-Bablok fit between paired FFR measurements by TruePhysioTM Microcatheter and PW.

Slope of Passing-Bablok fitDuration of FFR measurement

Slope of Passing-Bablok fit between paired FFR measurements by TruePhysioTM Microcatheter and PW.

PW FFR measurements with TruePhysioTM Microcatheter across and not across lesionDuration of FFR Procedure

Comparisons between PW FFR measurements with TruePhysioTM Microcatheter across lesion and with TruePhysioTM Microcatheter not across lesion, including bias, as assessed by Bland-Altman analysis.

Rate of clinically significant driftDuration of FFR measurement

Rate of clinically significant drift (drift \>0.03), for each system, and comparison between the two systems.

Diagnostic FFR concurrence of functionally significant stenosisDuration of FFR measurement

Concurrence of TruePhysioTM Microcatheter FFR diagnostic accuracy of functionally significant stenosis, using PW FFR ≤0.80 as the reference.

Device success rateDuration of FFR measurement

Device success rate, defined as a valid FFR reading for each system, and comparison between the two systems.

Rate of device-related adverse effectsDuration of FFR Procedure

Rate of device-related adverse effects, for each system individually, and comparison between the two systems.

Sensitivity, Specificity of TruePhysioTM Microcatheter in determining functionally significant stenosisDuration of FFR measurement

Sensitivity, Specificity of TruePhysioTM Microcatheter in determining functionally significant stenosis at the vessel level with PW FFR as the reference standard (PW FFR ≤0.80 as positive case).

Mean driftDuration of FFR measurement

Mean drift, defined as the absolute difference between Pd/Pa at the equalization position after pullback and 1.00, for each system, and comparison between the two systems.

Trial Locations

Locations (4)

Guangdong General Hospital

🇨🇳

Guangzhou, China

Second Affiliated Hospital, School of Medicine, Zhejiang University

🇨🇳

Hangzhou, China

Shanghai Zhongshan Hospital

🇨🇳

Shanghai, China

Shenzhen People's Hospital

🇨🇳

Shenzhen, China

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