We recently validated a novel software to calculate vessel fractional flow reserve (vFFR) based on 3D- quantitative coronary angiography without the need for a dedicated pressure wire or hyperemic agent . In the retrospective FAST I study, vFFR showed a high diagnostic accuracy in assessing functional lesion significance as compared to Fractional Flow Reserve (FFR) along with a low interobserver variability (r = 0.95) in an off-line setting when computed by blinded academic observers . The diagnostic accuracy of the technique was subsequently confirmed in the prospective, multicenter FAST II study in which vFFR was computed offline by a blinded Core Lab as well as by local study personnel .