Fully automated quantitative coronary angiography versus optical coherence tomography guidance for coronary stent implantation (FLASH): Study protocol for a randomized controlled noninferiority trial
- Author(s)
- Yongcheol Kim; Hanbit Park; Hyuck-Jun Yoon; Jon Suh; Si-Hyuck Kang; Young-Hyo Lim; Duck Hyun Jang; Jae Hyoung Park; Eun-Seok Shin; Jang-Whan Bae; Jang Hoon Lee; Jun-Hyok Oh; Do-Yoon Kang; Jihoon Kweon; Min-Woo Jo; Duk-Woo Park; Young-Hak Kim; Jung-Min Ahn
- Keimyung Author(s)
- Yoon, Hyuck Jun
- Department
- Dept. of Internal Medicine (내과학)
- Journal Title
- Am Heart J
- Issued Date
- 2024
- Volume
- 275
- Abstract
- Background:
Artificial intelligence-based quantitative coronary angiography (AI-QCA) has been developed to provide a more objective and reproducible data about the severity of coronary artery stenosis and the dimensions of the vessel for intervention in real-time, overcoming the limitations of significant inter- and intraobserver variability, and time-consuming nature of on-site QCA, without requiring extra time and effort. Compared with the subjective nature of visually estimated conventional CAG guidance, AI-QCA guidance provides a more practical and standardized angiography-based approach. Although the advantage of intravascular imaging-guided PCI is increasingly recognized, their broader adoption is limited by clinical and economic barriers in many catheterization laboratories.
Methods:
The FLASH (fully automated quantitative coronary angiography versus optical coherence tomography guidance for coronary stent implantation) trial is a randomized, investigator-initiated, multicenter, open-label, noninferiority trial comparing the AI-QCA-assisted PCI strategy with optical coherence tomography-guided PCI strategy in patients with significant coronary artery disease. All operators will utilize a novel, standardized AI-QCA software and PCI protocol in the AI-QCA-assisted group. A total of 400 patients will be randomized to either group at a 1:1 ratio. The primary endpoint is the minimal stent area (mm 2 ), determined by the final OCT run after completion of PCI. Clinical follow-up and cost-effectiveness evaluations are planned at 1 month and 6 months for all patients enrolled in the study.
Results:
Enrollment of a total of 400 patients from the 13 participating centers in South Korea will be completed in February 2024. Follow-up of the last enrolled patients will be completed in August 2024, and primary results will be available by late 2024.
Conclusion:
The FLASH is the first clinical trial to evaluate the feasibility of AI-QCA-assisted PCI, and will provide the clinical evidence on AI-QCA assistance in the field of coronary intervention.
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