Abstract
Over the past two decades, invasive coronary physiology assessment has advanced significantly. Despite the proven prognostic significance provided by invasive physiological assessment of lesions by means of fractional flow reserve or adenosine-free non-hyperaemic pressure ratios, challenges in clinical practice hinder widespread adoption and limit additional value for optimising percutaneous coronary intervention decisions. Despite notable progress, uncertainties persist, emphasising the need for further research to establish a single numerical parameter in the diagnosis of a functionally significant disease, clarify the impact of longitudinal vessel analysis, and support the relevance of pressure indices in post-intervention optimisation.
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