Intracoronary stents are, without any doubt, a major breakthrough in interventional cardiology. Their widespread use has expanded to more difficult anatomical situations and the search for more suitable stents continues to grow. We review, in this paper, the technical characteristics of stents that are currently approved or in clinical investigation. We have also reviewed the role of intravascular ultrasound in the study of the anatomical characteristics of plaque, the length of the lesion, and their influence of the stent selection and the ultrasound influence on the determination of appropriate stent expansion. After reviewing the current role of the intracoronary stent, we tried to look for the most appropriate stent in three "unconventional" anatomical situations: long and bifurcated lesions, lesions containing thrombus and saphenous vein aortocoronary bypass grafts. In conclusion, the intracoronary stent plays a major role in interventional cardiology. The second and third generation stents are more suitable for "specially difficult" situations, but there are some lesions such as bifurcations where the is not yet a definitive solution.