42 year-old male presented with new onset CCS Class II angina and positive stress MPI for moderate inferior and inferolateral ischemia. A Cardiac Cath on September 4, 2014 revealed II vessel CAD; total occlusion of distal RCA with collaterals filling via LAD and 80% lesions in LCx branches- OM2 and LPL1. Patient underwent successful Ambulatory PCI of LCx branches- OM2 and LPL1 with Promus Premier DES and did well. Patient is now planned for staged PCI of distal RCA CTO via antegrade/retograde approach.