Balloon PTCA for the distal, long, eccentric coronary artery stenosis will be at high risk for severe dissection or acute occlusion during or after procedure.

High Speed Rotational Atherectomy followd by low pressure balloon angioplasty due to distal, long, eccentric coronary artery stenosis. Rotational coronary atherectomy debulked the lesion quickly without difficulty. Rotational Coronary Atherectomy with adjuctive low pressure balloon inflation was successful without event.

This case illustrates the point that complementary deployment of devices may not only improve success of percutaneous coronary intervention, but also may extend its scope.