Therefore, DES should not be used in the presence of financial barriers to continuing prolonged DAPT, social barriers that may limit patient compliance, or medical issues involving bleeding risks or the need for invasive or surgical procedures in the following year that would interrupt antiplatelet therapy. The need for use of long-term warfarin and the associated in- creased risk of bleeding with long-term triple therapy is also a consideration in deciding on DES versus BMS.480 Patients implanted with most contemporary coronary stents can undergo magnetic resonance imaging (MRI) examination any time after implantation.481,482 The effect of the MRI examination on heating of the drug or polymer coating used in DES is unknown. There is no indication for antibiotic prophylaxis before dental or invasive procedures in patients with coronary stents.483 5.4. Adjunctive Diagnostic Devices 5.4.1. FFR: Recommendation Class IIa 1. FFR is reasonable to assess angiographic intermedi- ate coronary lesions (50% to 70% diameter stenosis) and can be useful for guiding revascularization decisions in patients with SIHD.12,97,484 486 (Level of Evidence: A) See Online Data Supplement 23 for additional data regarding FFR. The limitations of coronary angiography for determination of lesion severity have been well described. Angiography may under- or overestimate lesion stenosis. Various physio- logic measurements can be made in the catheterization laboratory, including coronary flow reserve and FFR. 