Multimodality Assessment of Intermediate Left Main Stenosis: Comparison of Optical Coherence Tomography-derived Minimal Lumen Area, Invasive Fractional Flow Reserve and FFRCT

What this Trial Is About

Researchers are investigating the best way to assess the severity of intermediate narrowing in the left main coronary artery, which is linked to poor outcomes. The study compares three methods: optical coherence tomography (OCT) derived minimal lumen area (MLA), invasive fractional flow reserve (FFR), and noninvasive computed tomography angiography-based FFR (FFRCT). This research aims to find the optimal OCT-MLA cut-off and evaluate FFRCT's diagnostic accuracy against FFR as the reference standard. Participants undergo a multimodality assessment including OCT, invasive FFR, coronary computed tomography angiography (CTA), and FFRCT. OCT is a newer imaging technique with higher resolution than IVUS, while FFR measures blood flow impact on lesions invasively. FFRCT uses computational fluid dynamics to predict blood flow noninvasively from CTA images. The study compares these methods specifically for intermediate left main stenosis to determine their accuracy and usefulness. During the procedure visit, participants receive OCT, FFR, CTA, and FFRCT assessments to measure coronary artery narrowing and blood flow. Researchers collect multiple measurements and compare the results. Clinical outcomes are also followed for one year. This includes monitoring symptoms, imaging, and other clinical endpoints to evaluate the diagnostic methods' predictive value and safety. The total participation timeline includes baseline procedure assessments and a one-year follow-up period.

Comparison of Optical Coherence Tomography-derived Minimal Lumen Area, Invasive Fractional Flow Reserve and FFRCT