74 year old male with CKD Stage III presented with CCS Class II angina and positive stress MPI for moderate inferoapical ischemia. A Cardiac Cath on July 6, 2018 revealed 3 V CAD: subtotal mid LAD (Medina 0,1,1) with 95% bifurcating LAD-D2, 90% proximal LCx, 95% RPDA and 80% RPL with SYNTAX Score of 22 and LVEF = 60%. On July 6, 2018 patient underwent PCI to RPDA and RPL1 using two Promus Premier DES and then successful PCI of prox LCx using Promus Premier DES. Patient continues to have CCS Class II angina on tolerated medical therapy. Patient is now planned for staged PCI of mid LAD-D2 bifurcation using dedicated 2-stent technique.