Angiographically undetected stent malapposition resolved by intravascular ultrasound and flow imaging

Intravascular ultrasound (IVUS) has emerged as an important technique for arterial imaging during coronary stent implantation. Additionally, an auxiliary technique for flow visualization using IVUS has been recently introduced. At present, most stents are poorly visualized by angiography since most of them are not radiopaque. Conversely, IVUS provides adequate visualization of the arterial wall and of the position of stent struts. We report on a case where incomplete apposition of a stent, which was not revealed by corollary angiography, was detected by IVUS and flow imaging and subsequently corrected by additional expansion of the stent.