Fig. 1: Step-wise approach of performing intravascular imaging in ACS.

*The use of DCB instead of DES may be appropriate but remains to be validated by future clinical trials. **High-risk patients indicate those having ongoing ischemia/hemodynamic instability and high-risk anatomy indicates left main or proximal 2-vessel SCAD, dashed lines indicate uncertain or secondary strategies, solid lines indicate more established and recommended strategies. CN Calcified Nodules, TIMI thrombolysis in myocardial infarction, SCAD Spontaneous Coronary Artery Dissection, NC Balloon Non-Compliance Balloon, DES Drug-Eluting Stent, DCB Drug-Coated Balloon.