Invasive and noninvasive methods currently used for imaging-based evaluation of the coronary tree reveal a high number of moderate degree coronary artery stenoses, and the decision to revascularize or not such lesions could be difficult in different clinical settings. Therefore, the need for evaluating the functional significance of such lesions appeared obvious and led to the introduction of fractional flow reserve methodology, a new tool proposed for the evaluation of the functional impact of a coronary stenosis. At the same time, new tools have been proposed for the same application, such as the transluminal attenuation gradient along a coronary artery stenosis, determined using cardiac computed angiography. The aim of this short update is to summarize the recent advances in the field of invasive and noninvasive evaluation of the functional significance of coronary artery stenoses.
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