This live case from Buffalo General Medical Center features single access technique, rotational atherectomy, IVUS, Shockwave intravascular lithotripsy and bifurcation stenting. Operator Vijay Iyer, MD, expertly manages this case which illustrates the benefits of pre-procedural planning and Impella® support. Dr. Iyer explains that doing these cases with Impella support changes the urgency and dynamics of the procedure as well as the completeness of the procedure. Seth Bilazarian, MD, with panelists Haroon Faraz, MD, and Jeff Tyler, MD, provide insightful commentary on all aspects of the case, notably the single access technique and bifurcation stenting strategies.