We need intracoronary physiology guidance before percutaneous coronary intervention, but do we need it post-stenting?

This editorial refers to ‘Post-stenting fractional flow reserve assessment versus coronary angiography for functional optimization of percutaneous coronary intervention (TARGET-FFR): a randomized controlled trial’, by D. Collison et al., https://doi.org/10.1093/eurheartj/ehab449. There was an important paradigm shift when physiology-guided percutaneous coronary intervention (PCI) using fractional flow reserve (FFR) was shown to reduce unnecessary stenting and improve clinical outcomes compared with angiography-guided PCI.1–3 FFR is the more traditional method for physiological evaluation, while newer resting indices such as the instantaneous wave-free ratio (iFR) alleviate the need for adenosine which makes the procedure even more rapid and comfortable for the patient.4,5 Although coronary physiology often is utilized to determine whether a lesion requires revascularization, using coronary physiology to evaluate the post-PCI result is relatively uncommon in contemporary clinical practice, Previous studies have shown that post-PCI FFR values of ≥0.90 are associated with a lower risk of repeat...