Case and Plan:
59-year old ESRD male with chronic CAD and s/p prior PCI’s, presented with typical CCS Class III angina, new decrease in EF and no stress test done. A Cardiac Cath on September 23, 2021 revealed 2 V CAD: multiple 90-95% calcified lesions in RCA, subtotal LCx-OM1 ISR, CTO LCx-LPL1 ISR with LVEF 50% and SYNTAX Score of 21. Patient underwent successful RotaDES PCI of RCA using two Promus Elite stents. Patient is now planned for IVUS guided staged PCI of complex LCx-OM1 & LPL1 CTO ISR using rotational atherectomy.