Intravascular ultrasound guidance for percutaneous coronary intervention in the current practice era

Intravascular ultrasound (IVUS) is an invasive imaging modality used to visualize coronary crosssectional anatomy. IVUS technology has been proven to be superior to coronary angio graphy for assessment of vessel size, plaque composition, calcium content and lesion severity [1–3]. The role of IVUS guidance after stent implantation has been previously explored; however, limited information is available on how the preprocedural use of IVUS might impact the intervention strategy and clinical outcome, parti cularly when approaching complex coronary lesions. We believe that IVUS provides additional information beyond angiography, often leading to more optimal results and improving the outcome after percutaneous coronary intervention (PCI). Given the continuous expansion of PCI for treating sicker patients and more complex coronary lesions, we believe that IVUS plays a central role in the current practice era. In this article, we examine the role of IVUS guidance for PCI in the current practice era in view of the latest clinical evidence.