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Expanding role of fractional flow reserve in the cardiac catheterization laboratory

“We could fractional flow reserve it...” This is a common refrain heard in many catheterization laboratories and, unfortunately, it has often been followed by either “Well, let’s just stent it...” or by “Let’s try another angle and maybe we will see it better...” There are a number of potential reasons why fractional flow reserve (FFR) has been underutilized in the catheterization laboratory, including a lack of under standing of the technique and/or of the data supporting its role in decision-making, the perception that it adds significant time and complexity to the procedure, and operator volume and financial considerations.