Intravascular ultrasound (IVUS) has been available for clinical use for many years.1 Despite its success in both diagnostic and therapeutic situations,2–8 its applications have been very limited. This apparent lack of enthusiasm for IVUS is based, in part, on the initial cost of purchasing the equipment and the recurrent expense of ultrasound probes, which are not reusable. In addition, until very recently, there were no CPT codes available for Medicare billing of IVUS procedures, and the procedure was a nonreimbursable cost to the institution. Even with the advent of usable codes, the disparity between the cost of the probe and potential reimbursement continues to create a financial disincentive to apply the technology. Thus, few centers employ IVUS on a routine basis, and most users apply it in selected or unusual cases where it would supply a specific piece of information not provided by angiography and computed tomography (CT).