Systems, devices, and methods for obtaining fractional flow reserve in the presence of a catheter. In a method of determining a fractional flow reserve in the presence of a catheter, the method comprises the steps of obtaining measurements of an inner luminal organ diameter proximal to, at, and distal to a stenosis and a length of the stenosis, obtaining a pressure drop measurement at the stenosis, calculating a volumetric flow of fluid through the inner luminal organ at the stenosis, and determining a stenotic pressure drop at the stenosis corresponding to dimensions of the guidewire as a function of the calculated volumetric flow of fluid through the inner luminal organ at the stenosis, wherein the stenotic pressure drop is indicative of a fractional flow reserve at or near the stenosis.