Case submitted by Jean Fajadet and Bruno Farah, Clinique Pasteur

Summary: Severely calcified distal left main and proximal left anterior descending (LAD) lesion; operators were hesitant to use rota; Shockwave IVL advanced with no pre-dilation required; 3.5 x12 mm IVL treatment performed and balloon waist resolved after 20 pulses; final result of widely patent artery with TIMI 3 flow post-stent (3.5 mm) with 4.5 mm NC post-dil.