55 year-old female presented with CCS class III angina and positive stress MPI for moderate ischemia in the anteroseptal and inferoposterior segments with mild inferior infarct. A Cardiac Cath on May 6, 2016 revealed 2V CAD: 95% prox RCA, total occlusion of distal RCA BMS instent-restenosis (ISR) filling via LAD collaterals, 90% mid LAD with normal systolic LV function; SYNTAX Score of 16. Patient underwent successful intervention of mid LAD using Promus Premier DES. Patient is now planned for IVUS/OCT guided rotational atherectomy and DES of totally occluded RCA BMS ISR.
