The Concept of Functional Percutaneous Coronary Intervention: Why Physiologic Lesion Assessment Is Integral to Coronary Angiography.

The gold standard for assessing the severity of coronary stenoses has been coronary angiography. However, multicenter randomized clinical trials have demonstrated that treatment decisions based on angiography alone do not guarantee benefit to patients. Fractional flow reserve provides physiologic lesion assessment of coronary stenoses. The use of physiology improves clinical outcomes when used for decision making for coronary revascularization. In the era of increased scrutiny of appropriateness of cardiac catheterization and percutaneous coronary intervention, the use of physiologic assessment of the severity of coronary stenoses should be considered an integral adjunct to the anatomic evaluation provided by the coronary angiogram.