Seth Bilazarian, MD, and panelists Michael Lim, MD, Stephane Rinfret, MD, and Louis Salvaggio, MD, provide commentary on this CAMP live case by Jeffrey Moses, MD, and Ziad Ali, MD, from St. Francis Hospital in Long Island, New York. The patient is a 69-year-old male with exertional chest pain and the case entails heavy calcification, a trifurcation, an ambiguous lesion in the ostial circumflex, and contrast-sparing techniques. Dr. Rinfret summarizes the case by stating “It’s a beautiful demonstration of integrating advanced imaging, good pre-procedural planning in order to avoid delivering contrast to a patient who’s high risk for AKI. Also, I think the [Impella] support in this case allowed the operator to be focusing on doing the best job possible.”