Practice and potential pitfalls of coronary pressure measurement

Guidewire-based coronary pressure measurement has emerged over the last years as a promising approach in the invasive assessment of coronary artery disease. It enables calculation of fractional flow reserve (FFR) which closely relates distal coronary pressure to myocardial blood flow during maximal arteriolar vasodilation. Coronary pressure measurement and FFR provide important information, both for decision making in diagnostic angiography and for monitoring and evaluating coronary interventions. In this review, the practical set-up of coronary pressure measurement in the catheterization laboratory is discussed step-by-step, special attention is given to potential pitfalls and how to avoid them, and the interpretation of coronary pressure measurement in a variety of pathologic conditions is clarified.