Intravascular imaging-guided percutaneous coronary intervention (PCI) has been shown to be associated with better clinical outcomes compared with angiography-guided PCI. The reasons for this are because intravascular imaging can inform operators of the need for lesion preparation and appropriate balloon or stent sizing and can also help to confirm optimal stent expansion and stent edge dissection or residual disease. In order to get these potentially better outcomes, operators must both recognize the information gained through intravascular imaging and react in a clinically appropriate manner [ ].