IVUS may be reasonable for the assessment of non left main coronary arteries with angiographi- cally intermediate coronary stenoses (50% to 70% diameter stenosis).489,496,497 (Level of Evidence: B) 2. IVUS may be considered for guidance of coronary stent implantation, particularly in cases of left main coronary artery stenting.490,495,498 (Level of Evidence: B) 3. IVUS may be reasonable to determine the mecha- nism of stent thrombosis.495 (Level of Evidence: C) Class III: NO BENEFIT 1. IVUS for routine lesion assessment is not recom- mended when revascularization with PCI or CABG is not being contemplated. (Level of Evidence: C) IVUS provides a unique coronary artery assessment of lesion characteristics, minimal and maximal lumen diameters, cross- sectional area, and plaque area. Diagnostic uses for IVUS include the assessment of angiographic indeterminant coro- nary artery stenoses, determination of the mechanism of stent restenosis or thrombosis, and postcardiac transplantation surveillance of CAD.488,490 492,499 For left main coronary artery stenoses, a minimal lumen diameter of 2.8 mm or a Table 11. Clinical Situations Associated With DES or BMS Selection Preference DES Generally Preferred Over BMS (Efficacy Considerations) BMS Preferred Over DES (Safety Considerations) Left main disease Small vessels In-stent restenosis Bifurcations Diabetes Long lesions Multiple lesions Saphenous vein grafts Unable to tolerate or comply with DAPT Anticipated surgery requiring discontinuation of DAPT within High risk of bleeding BMS indicates bare-mental stent(s); DAPT, dual antiplatelet therapy; and DES, drug-eluting stent(s). minimal lumen area of 6 mm2 suggests a physiologically significant lesion for which patients may benefit from revas- cularization. 