67 year old male presented with new onset CCS Class I angina and a positive ETT at early work load. A Cardiac Cath on May 8th, 2017 revealed calcific 2V and LM CAD: 80% distal left main with trifurcation, 80% proximal & mid LAD, 90% proximal LCx and 90% proximal Ramus Intermedius, SYNTAX Score of 44 and LVEF 46%. Patient underwent for Heart Team discussion and CABG was recommended, but patient declined CABG. Now planned for high risk PCI of calcified LM trifurcation lesion using rotational atherectomy and dedicated two stent techniques.