Tag Archives: instantaneous wave-free ratio

Introduction – why do we need coronary physiology? It is increasingly appreciated that only coronary stenoses severe enough to cause myocardial ischaemia should undergo revascularisation. Reliable assessment of stenosis severity is, therefore, vital. For many years, invasive coronary angiography was considered to be the gold-standard test for the identification of flow-limiting coronary artery disease. This was largely due to the ‘oculo-stenotic reflex’ – a powerful stimulus that leads operators to believe that ischaemia must be present based on the severity of the coronary stenosis from visual assessment alone. However, identifying i