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Figure 4 This is a coronary angiogram with corresponding intravascular ultrasound of the saphenous vein graft-right coronary artery. Panel A depicts severe neointimal hyperplasia (NIH) at the ostial location. The bright image at 1 to 4 o'clock is the Symmetry device (SD). The lumen (L) is barely visible at 4 to 7 o'clock owing to the extensive presence of NIH and appears as a dark crescent shaped area under the intravascular ultrasound catheter. Panel B shows a well-expanded stent with minimal NIH, and a widely patent lumen. Panel C shows a diffuse moderate-severe NIH in an area just distal to the stent that had progressed angiographically over the last two months. The black arrows indicate the position of the intravascular ultrasound catheter and corresponding image.