Coronary angiography has historically served as the gold standard for the diagnosis of coronary artery disease (CAD) and guidance of percutaneous coronary intervention (PCI). Adjunctive use of contemporary intravascular imaging (IVI) technologies has emerged as a complement to conventional angiography – to further characterize plaque morphology and optimize the performance of PCI. Intravascular ultrasound (IVUS) is the most widely used IVI modality which provides anatomic information in detail about vessel and lumen dimensions and atherosclerotic lesion characteristics including severity of stenosis, lesion length, and morphology [ , ]. There is increasing evidence that IVI-guided PCI improves clinical outcomes, but the adoption rate remains low [ ]. Very recently, the results of the RENOVATE-COMPLEX-PCI randomized trial showed that among patients with complex coronary artery lesions, IVI-guided PCI led to a lower risk of a composite of death from cardiac causes, target-vessel-related MI, or clinically driven target-vessel revascularization than angiography-guided PCI [ ].