Angiography-Derived Physiology for Coronary Artery Disease Assessment: Expert Opinion From a SCAI Roundtable

Abstract Angiography-derived physiology (ADP) is an emerging technique that offers streamlined, wire-free assessment of epicardial coronary physiology. This is accomplished by applying computational fluid dynamics or, in some cases, mathematical formulas in conjunction with artificial intelligence to standard coronary angiographic images. This approach represents a potential paradigm shift in the catheterization laboratory workflow. Despite its early promise, obstacles to the adoption and routine use of ADP remain. This document represents expert opinion from a scientific roundtable on ADP for coronary artery assessment sponsored by the Society for Cardiovascular Angiography & Interventions. It provides a comprehensive overview of the underlying concepts of ADP, outlines its optimal clinical application based on current evidence, highlights key advantages and limitations, reviews available software solutions, and discusses future directions.