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NCT Number: NCT05682118

Impact of Dynamic CoROnary RoADmap System for Guidance of Instantaneous Wave-Free Ratio or Fractional Flow Reserve

In patients with 50-90% stenosis of the coronary artery, the coronary roadmap (dynamic roadmap) is performed when the conventional fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) are performed. coronary roadmap system) to confirm the effectiveness of the function.

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Key information

Age range

19 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Yongcheol Kim

Yongin, Gyeonggi-do, 16995, South Korea

Location status: Recruiting

Location contact

Deok-Kyu Cho, MD

SUB_INVESTIGATOR

Eui Im, MD

SUB_INVESTIGATOR

Ji Woong Roh, MD, PhD

SUB_INVESTIGATOR

Oh-Hyun Lee, MD

SUB_INVESTIGATOR

Yongcheol Kim, MD

CONTACT

[email protected]

+823151898967

Yongcheol Kim, MD, PhD

PRINCIPAL_INVESTIGATOR

About this study

In coronary angiography, 50% or more stenosis of the causative vessel is observed in a patient with stable angina pectoris (SAP) or 50% or more stenosis of a non-causative vessel is observed in acute coronary syndrome (ACS) Based on 0.90, if it is less than 0.89, PCI is performed, and if it is 0.90 or more, drug treatment is performed. When the pressure wire tests are performed, the pressure wire is inserted from the origin of the blood vessel through the lesion to the distal portion, and the pressure wire is placed at the distal end of the blood vessel for measurement. In this process, there are many cases where the pressure wire escapes the branch blood vessel or does not pass through well. It takes a long time to stand up and evaluate stenosis, and in many cases, an additional contrast medium is used to additionally check blood vessel travel and to check the position and condition of the pressure wire. To overcome this, the software roadmap installed in the cardiac fluoroscopy device of the cardiac catheterization room can be helpful. However, there are currently no studies related to roadmaps in coronary artery examination. Therefore, in this study, we want to evaluate the effectiveness of the roadmap when examining FFR and iFR.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients aged 19 years or older
  • Patients with stable angina, including asymptomatic ischemic heart disease, who have 50-90% stenosis of the causative vessel by coronary angiography
  • Acute coronary syndrome patients with multivessel disease and 50-90% stenosis of non-caused vessels that did not cause acute coronary syndrome
  • Patients who voluntarily decided to participate in this study and gave written consent to the subject consent form

Exclusion criteria

  • Patients with acute coronary syndrome and single vessel disease
  • Patients who have undergone previous coronary artery bypass grafting
  • Poor coronary blood flow (TIMI grade ≤ 2)
  • If life expectancy is less than one year
  • Women who are pregnant or wish to become pregnant

Treatment and study plan

roadmap

Procedure

FFR and iFR tests using the roadmap system, or FFR and iFR tests without using the roadmap system.

Pressure wire into guiding catheter The equalization of the pressure wire with the aortic pressure(after placing the pressure wire on the tip of the guiding catheter and removal of contrast media by saline flushing) and the placement of the pressure wire on the distal of the blood vessel to measure iFR. After iFR measurement, the pressure wire was pulled back into the tip of the guiding catheter to check the presence of pressure drift. A final Pd/Pa between 0.97 and 1.03 is considered acceptable. Following confirming no pressure drift, a mode change will be done from iFR to FFR, and then a re-check of the time between the equalization of the pressure wire with the aortic pressure will be planned. In all lesions, FFR value were measured with hyperemia, achieved by intracoronary (IC) bolus injection of nicorandil (Sigmart®; Chugai Pharmaceutical Co., Ltd., Tokyo, Japan) 2 mg.

iFR/FFR

Procedure

Patients undergoing pressure wire test with moderate stenosis. Pressure wire into guiding catheter The equalization of the pressure wire with the aortic pressure(after placing the pressure wire on the tip of the guiding catheter and removal of contrast media by saline flushing) and the placement of the pressure wire on the distal of the blood vessel to measure iFR. After iFR measurement, the pressure wire was pulled back into the tip of the guiding catheter to check the presence of pressure drift. A final Pd/Pa between 0.97 and 1.03 is considered acceptable. Following confirming no pressure drift, a mode change will be done from iFR to FFR, and then a re-check of the time between the equalization of the pressure wire with the aortic pressure will be planned. In all lesions, FFR value were measured with hyperemia, achieved by intracoronary (IC) bolus injection of nicorandil (Sigmart®; Chugai Pharmaceutical Co., Ltd., Tokyo, Japan) 2 mg.

Primary outcomes

  1. iFR time

    Time frame: Through procedure completion, up to 24 hours

    iFR time: the time interval between the pressure wire into the guiding catheter and the placement of the pressure wire on the distal of the blood vessel to measure iFR

  2. FFR time

    Time frame: Through procedure completion, up to 24 hours

    FFR time: the time interval between the equalization of the pressure wire for FFR and the placement of the pressure wire on the distal of the blood vessel to measure FFR

Secondary outcomes

  1. Success rate of placement of the pressure wire on the distal of the blood vessel to measure iFR/FFR

    Time frame: Through procedure completion, up to 24 hours

    The success rate of advancing pressure wire to a target vessel distally

  2. Use of contrast medium until the pressure wire is advanced to the distal end of the blood vessel

    Time frame: Through procedure completion, up to 24 hours

    Use of contrast medium until the pressure wire is advanced to the distal end of the blood vessel

  3. The amount of contrast medium used until the pressure wire is advanced to the distal end of the blood vessel

    Time frame: Through procedure completion, up to 24 hours

    The amount of contrast medium used until the pressure wire is advanced to the distal end of the blood vessel

  4. Total procedure time to assess functional significance using iFR/FFR pressure wire

    Time frame: Through procedure completion, up to 24 hours

    Total procedure time between insertion and out of guiding catheter via a sheath

  5. Total procedure time

    Time frame: Through procedure completion, up to 24 hours

    Total procedure time

  6. Total amount of contrast media usage

    Time frame: Through procedure completion, up to 24 hours

    Total amount of contrast media usage

  7. Total dose of radiation exposure

    Time frame: Through procedure completion, up to 24 hours

    Total dose of radiation exposure

  8. Complications related to the procedure

    Time frame: Through procedure completion, up to 24 hours

    Complications related to the procedure

Study contacts

Contact information is provided by the study sponsor or research team.

Ji Woong Roh, MD, PhD

CONTACT

[email protected]

+823151898792

Yongcheol Kim, MD, PhD

CONTACT

[email protected]

+823151898967

Sponsors and collaborators

Lead sponsor

Yonsei University

Other

Collaborators

  • Philips Healthcare

Registry information

Official study title

Impact of Dynamic CoROnary RoADmap System for Guidance of Instantaneous Wave-Free Ratio or Fractional Flow Reserve: A Single-Center, Randomized Study (ROAD-IFR Trial)

Acronym: ROAD-IFR

Important dates

Study start
2023
Primary completion
2026
Study completion
2026
First posted
Jan 12, 2023
Registry last updated
Feb 11, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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