How frequently do you opt to use IVUS as opposed to OCT or invasive hemodynamic assessment when evaluating coronary lesions?   

In my non-academic practice, the order of frequency use is FFR>OCT>IVUS. I suspect that interventionalists varies in their response to this question. Personally, I limit its use to morphological assessment of ostial lesion and in patients with CKD (since OCT requires contrast). Therefore, IVUS...

For questions of lesion significance, I rely on FFR. But I use IVUS on nearly all PCI's for vessel sizing, plaque characteristics, and then stent results. Tend to favor IVUS over OCT because will often do 2-3 IVUS runs (or more) for stent optimization and want to avoid multiple contrast boluses. Ar...