This elderly woman of 76 y.o. is admitted directly in the cath lab from the emergency department for chest pain and an ECG showing important ST depression in the anterior leads. She is sent directly to the cath lab due to limit blood pressure at 90mmhg. Coronary angiography found a distal calcified left main sub-occlussion (block of calcium in the distal LM). Syntax score 17, CRUSADE high, GRACE high. PCI was decided a few hours later, during the Heart Team meeting. After wiring the CX, rotablation was performed, followed by pre-dilatation and LM-CX stent implantation. POT, side branch (LAD) balloon and RE-POT was performed, with a good angiographic result at the end of the procedure. Would you have treated otherwise?

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