Hi Steve , I think IVUS imaging is now considered better then an angiogram but only used so far in about 20% of cases due to reimbursement issues. IVUS is better at detecting calcification inside arterial walls that may be constricting blood flow and thus enables better use of IVL technology . I suggest you ask your interventionist / Cardiologist his views on IVUS for imaging and IVL for below the knee applications. If he doesn't use any of these procedures maybe he could recommend some who does for a second opinion.
Most of the major teaching hospitals ( like UCSF out here ) will be using IVUS for imaging and when appropriate IVL to increase blood flow or to prepare the artery for a drug eluting stent.
Not medical advice ...just my opinion Best of luck Kiwi