81 year-old male presented with new onset CCS Class III angina with positive stress echo for multi-vessel ischemia. A Cardiac Cath on December 2, 2016 revealed 3 V CAD: 70% proximal RCA with subtotal small RPDA; 90% proximal LAD, 100% D1, 80% proximal LCx with 95% angulated OM1 bifurcation lesion (Medina 1, 1, 1), SYNTAX score of 37 and normal systolic LV function. Patient underwent Heart Team discussion and elected for multi-vessel staged PCI. Patient underwent successful intervention of proximal LAD using Atherotomy and Promus Premier DES. He still has class II angina on MMT. Patient is now planned for staged PCI of angulated LCx-OM1 bifurcation lesion with dedicated two stent strategy.