Systematic Evaluation by Randomisation of Intracoronary physiological techniques for Assessing tandem Lesions
King’s College London
Duration of Study in the UK
3 years, 0 months, 1 days
The heart receives its own blood supply via a branching network of coronary arteries, which can become gradually narrowed by deposition of fat. Coronary artery disease occurs due to this narrowing. Up to one-third of patients have serial disease (two or more adjacent narrowings) on coronary angiography.
At present it is not possible to objectively assess serial disease. Narrowing of the coronary arteries is usually graded by an eyeball estimate on an x-ray-based test called an angiogram. In patients with a single narrowing (not serial disease) assessment of effect of a narrowing on blood flow is performed with pressure-wire derived indices. Treatment based on pressure-wire derived indices has been shown to improve symptom free survival, compared to angiography alone. To overcome this the two main pressure-wire derived indices FFR (Fractional Flow Reserve) and iFR (Instantaneous Flow Reserve) offer techniques for determining the amount blood flow impaired by each narrow, in serial disease. However, the accuracy of these have not be assessed.
We will assess the accuracy of FFR and iFR to determine the significance of each narrowing for patients with serial disease.
The findings of this study will establish the accuracy of pressure-wire derived indices (FFR and iFR) for determining the significance of each narrowing in serial disease and if one is better than the other at guiding management. This should lead to objective assessment of these narrowing’s and enable doctors to offer patient specific and tailored treatment options, which may result in avoiding unnecessary stenting or surgery.
Wales REC 1
Date of REC Opinion
9 Aug 2021