82 year old female presented with new onset CCS Class III-IV angina and exertional dyspnea; no stress test done. A Cardiac Cath done via right radial approach on September 5, 2017 revealed III Vessel CAD: 60% proximal RCA, heavily calcified 90% mid LAD and 80% D1 bifurcation, 95% ulcerated LCx-OM1 with SYNTAX Score of 22 and LVEF = 60%. Patient underwent successful intervention of LCx-OM1 (Xience DES). Patient is now planned for FFR guided staged PCI of LAD-D1 bifurcation using rotational atherectomy of both branches and dedicated two stent technique.