Angiography alone for procedural image guidance in the catheterization lab is sometimes not enough, and it is helpful to augment X-ray lumen imaging with intravascular ultrasound (IVUS) or optical coherence tomography (OCT) to visualize the soft tissue morphology. 

Key to ongoing U.S. healthcare reform are efforts to reduce costs by eliminating unnecessary medical procedures and using information technology (IT) to justify costs that are incurred to make providers more accountable. Key medical societies in each subspecialty will be responsible for what standards of care should be set and what guidelines should be followed. In the cath lab, fractional flow reserve (FFR) is already viewed as the gold standard for determining the hemodynamic impact of coronary lesions, acting as a gatekeeper to whether a patient is stented or receives medical therapy alone. For this reason, FFR is already being predicted as the measurement of record that will be required in documentation for stent reimbursement in the future.