Functional assessment of coronary stenoses: can we live without it?

Eur Heart J. 2013 May;34(18):1335-44. doi: 10.1093/eurheartj/ehs436. Epub 2012 Dec 19.


When selecting coronary stenoses for interventional treatment, assessment of reversible ischaemia is paramount from a symptomatic as well as prognostic point of view. Fractional flow reserve (FFR) is now considered the gold standard for invasive assessment of ischaemia. By measuring FFR in the catheterization laboratory, one can accurately identify which lesions should be stented resulting in improved patient outcome in most elective clinical and angiographic conditions. Recently, in the European Society of Cardiology guidelines on coronary revascularization, FFR was upgraded to an IA classification in multivessel percutaneous coronary intervention. In this review paper, the rationale for routine measurement of FFR will be reviewed and studies supporting its integration into everyday practice will be highlighted.

Keywords: Coronary artery stenosis; Fractional flow reserve; Functional assessment; Pressure wire.

Publication types

  • Review

MeSH terms

  • Cardiac Catheterization / methods
  • Clinical Trials as Topic
  • Coronary Stenosis / diagnosis
  • Coronary Stenosis / etiology
  • Coronary Stenosis / physiopathology*
  • Fractional Flow Reserve, Myocardial / physiology*
  • Humans
  • Myocardial Ischemia / complications
  • Myocardial Revascularization
  • Prognosis