The concept of functional revascularization

Detection and reduction of inducible myocardial ischemia is a key moment in management of patients with stable coronary artery disease. It has been shown that coronary angiography as well as non-invasive stress testing fails to inform about true hemodynamic significance of individual stenosis in certain subsets of coronary anatomies. Intervention of non-significant lesion is associated with worse prognosis than optimal medical treatment. Using invasive measurement of myocardial fractional flow reserve (FFRmyo) for decision to perform or defer percutaneous coronary intervention was superior to angiographical guidance. Revascularization of functionally significant lesions and medical management of non-significant ones is the base of concept of functional revascularization and FFRmyo may be a tool, which provides information needed for such clinical decision.