Clinical implications of intravascular ultrasound imaging for stenting procedures.
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While quantitative coronary angiography (QCA) remains the standard used to assess new interventional therapies, there is a growing interest in the use of intracoronary ultrasound (ICUS) as an additional imaging technique. During the past years, ICUS has taught us that even the most perfect angiogram after stent placement can be misleading. The study of Blessing et al1 in this issue of the Journal shows that ICUS can be reliably used for lumen measurements in stents and in reference segments. However, it also showed a high variability between observers in the degree of stent expansion, which could lead to different therapeutic strategies. Is the clinical implication of this paper that ICUS is hard to use to determine optimal stenting results? As the authors point out, many other studies are presenting results of ICUS and stenting; but are those studies comparable?