Coronary flow reserve versus geometric measurements of coronary dimensions: Advantages and limitations of the functional stenosis assessment

This article reviews the physiopathological background of invasive functional assessment of coronary artery stenoses and the recent developments for clinical decision making based on intracoronary flow and pressure measurements. Limitations of these recordings are stressed, as well as their present clinical application to guide the decision of performing an intervention, or to assess the results of a percutaneous procedure. The additional value over (quantitative) angiography and intravascular ultrasound is discussed. Finally, the potentials of a new method of coronary flow measurement, based on the processing of the radiofrequency IVUS signal, offering combined simultaneous morphological and physiological assessments, are briefly introduced.