Multiple lesions treated down the RCA despite delivery issues with pre-dilation devices

Multi-lesion RCA; Couldn’t advance guideliner to distal lesion despite predilation; advanced 3.5mm IVL catheter as far as possible (1); delivered one cycle (10 pulses) and vessel opened; pulled back to the ostium (2) and vessel opened after one cycle (10 pulses); advanced to distal lesion (3) and vessel opened after one cycle (10 pulses); easily delivered 80mm of DES.