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Coronary pressure measurement, using a 0.014-inch pressure wire, has been widely used for the measurement of Instantaneous Wavefree Ratio (iFR), which is a new physiological index of coronary artery severity calculated during a wave-free period and without hyperaemic stimulation, with good repeatability [1–4]. Recently, an iFR value of 0.89 was used as a threshold cut-off value in two multi-centre, randomised, clinical trials that investigated whether the iFR was non-inferior to Fractional Flow Reserve (FFR). These studies revealed that the iFR-guided revascularization strategy was non-inferior to the FFR-guided revascularization strategy, in terms of Major Adverse Cardiac Events (MACE) at 12 months [5,6]. The use of a guiding catheter has been recommended for assessing coronary pressure measurement [7]. In Japan, following coronary angiography, a 4Fr or 5Fr diagnostic catheter has been often used for pressure assessment in cases presenting with intermediate coronary stenosis; however, the variation in iFR values between the 4Fr and 5Fr diagnostic catheter has not been elucidated. The present study aimed to evaluate the differences in iFR values, safety, and the rate of successful iFR measurement between the 4Fr and 5Fr diagnostic catheters. A RT I C L E I N F O

Measurement of Instantaneous Wave-free Ratio through a Diagnostic Catheter: Comparison of the Results between 4Fr and 5Fr