What is new in intracoronary physiology in 2026 and why does it matter?

Javier Escaned and Niels Van Royen explore the evolving role of physiology in coronary assessment, with a focus on angiography-derived and imaging-derived indices, highlighting the growing potential of AI-driven tools to integrate anatomical and functional data, enabling more comprehensive and flexible decision-making without the need for pressure wires. While these technologies offer significant advantages, including real-time guidance and improved lesion localisation, challenges remain regarding heterogeneity between systems and the need for robust clinical validation. The conversation also addresses the complementary role of OCT-derived physiology and the ongoing challenges in diagnosing and managing microvascular dysfunction, underscoring the complexity and rapid evolution of the field.

This interview was filmed at EuroPCR 2026: see more videos here.