This study will assess the differences between Fractional Flow Reserve (FFR) measurements made by the Navvus catheter and a commercially available pressure guidewire in up to 240 subjects where FFR is clinically indicated. All subjects will receive diagnostic treatment according to clinical indications and center standard practice.
The ACIST-FFR study is a prospective, open label, observational, multi-center study designed to assess the differences, if any, between FFR measured by the Navvus catheter and a commercially available 0.014-inch pressure guidewire (St. Jude Medical, Volcano, hereafter referred to as the PW) in subjects with coronary artery disease (CAD) undergoing coronary angiography. This will be accomplished by comparing the FFR measurement obtained with the ACIST Medical Systems RXi System and Navvus catheter with the FFR measurement obtained by using a PW within the same subject across the same target lesion at the same time.
Study Type
OBSERVATIONAL
Enrollment
240
Provide hemodynamic information for the diagnosis and treatment of coronary and peripheral artery disease. The system is intended for use in catheterization and related cardiovascular specialty laboratories to compute and display fractional flow reserve or FFR. Measurement of FFR requires simultaneously monitoring the blood pressures proximal and distal to a lesion. The RXi system includes a single use catheter (Navvus) with a pressure sensor for acquisition of the distal pressure. The proximal pressure is acquired by the guide catheter via an interface to the hospital hemodynamic monitor. The Navvus catheter interfaces to the RXi system console which includes embedded software, a user interface touch screen and associated electronics.
Provide hemodynamic information for the diagnosis and treatment of coronary and peripheral artery disease. The system is intended for use in catheterization and related cardiovascular specialty laboratories to compute and display fractional flow reserve or FFR.
Scripps Green Hospital
La Jolla, California, United States
Long Beach VA Medical Center
Long Beach, California, United States
Stanford School of Medicine
Stanford, California, United States
FFR Measurements
Bias between Navvus and PW FFR measurements, as assessed by Bland-Altman analysis
Time frame: Duration of FFR Procedure
Slope of Passing-Bablok
Slope of Passing-Bablok fit between paired FFR measurements by Navvus and PW
Time frame: Duration of FFR Procedure
Intercept of Passing-Bablok
Intercept of Passing-Bablok fit between paired FFR measurements by Navvus and PW
Time frame: Duration of FFR Procedure
Comparability of FFR Measurements
Comparability of PW FFR and Navvus FFR measurements at PW FFR=0.80, by Passing-Bablok analysis.
Time frame: Duration of FFR Procedure
Diagnostic FFR concurrence of stenosis significance
Concurrence of Navvus FFR diagnostic accuracy of stenosis significance, using PW FFR ≤0.80 as the standard.
Time frame: Duration of FFR Procedure
Device success rate
Device success rate, defined as a valid FFR reading, for each system individually, and comparison between the two systems.
Time frame: Duration of FFR Procedure
Mean drift
Mean drift, defined as the absolute difference between Pd/Pa at the equalization position after pullback and 1.00, for each system individually, and comparison between the two systems.
Time frame: Duration of FFR Procedure
Rate of clinically significant drift
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Medstart Washington Hospital Center
Washington D.C., District of Columbia, United States
University of Chicago Medicine
Chicago, Illinois, United States
Iowa Heart Center
West Des Moines, Iowa, United States
Metropolitan Cardiology Heart and Vascular Institute
Minneapolis, Minnesota, United States
University of Minnesota
Minneapolis, Minnesota, United States
Saint Louis University
St Louis, Missouri, United States
Columbia University Medical Center / New York Presbyterian Hospital
New York, New York, United States
...and 2 more locations
Rate of clinically significant drift, defined as drift \>0.03, for each system individually, and comparison between the two systems.
Time frame: Duration of FFR Procedure
Rate of device-related adverse effects
Rate of device-related adverse effects, for each system individually, and comparison between the two systems.
Time frame: Duration of FFR Procedure
PW FFR measurements with Navvus across and not across lesion
Comparisons between PW FFR measurements with Navvus across lesion and with Navvus not across lesion, including bias as assessed by Bland-Altman analysis.
Time frame: Duration of FFR Procedure
Comparison of FFR Measurements including bias
Comparisons between PW (with Navvus present in lesion) and Navvus FFR measurements, including bias assessed by Bland-Altman analysis.
Time frame: Duration of FFR Procedure
Correlation between Navvus diagnostic accuracy, bias, and angiographic characteristics
Relationship between Navvus diagnostic accuracy, bias, and angiographic characteristics such as lesion length and reference vessel diameter.
Time frame: Duration of FFR Procedure
PW Pd/Pa diagnostic concurrence of stenosis signficance
PW Pd/Pa diagnostic accuracy (concurrence) of stenosis significance, using PW FFR ≤0.80 as the standard.
Time frame: Duration of FFR Procedure
PW Pd/Pa measurements with Navvus across and not across lesion
Comparisons between PW Pd/Pa measurements with Navvus across lesion and with Navvus not across lesion, including bias as assessed by Bland-Altman analysis.
Time frame: Duration of FFR Procedure
Comparison of Pd/Pa Measurements including bias
Comparisons between PW (with Navvus present in lesion) and Navvus Pd/Pa measurements, including bias assessed by Bland-Altman analysis.
Time frame: Duration of FFR Procedure