Complex PCI of Tortuous Calcified RCA using Rotational Atherectomy with Guide Extension Catheter

43-year-old morbidly obese male with ESRD on HD presented with new onset Class IV angina and NSTEMI (pTnI 2:1U). A Cardiac Cath on February 26, 2021 revealed 2 V CAD: multiple calcified 80-99% lesions in extremely tortuous RCA, 90% mid LAD, LVEF = 55% and SYNTAX Score of 27. Patient underwent successful intervention of mid LAD using Xience DES. Patient is now planned for staged PCI of tortuous calcified RCA using rotational atherectomy with guide extension catheter and final OCT imaging.