Operation performed in King Fahed Armed Forces Hospital – Jeddah by Dr. Mervat Al-Asnag (IC) & Dr. Khaled Shaibi (IC). Patient J. A. suffered from a thrombosed and heavily calcified proximal to mid right coronary artery, which was initially treated in December 2018 for chronic totally occluded vessel but wasn’t completely dilated. In march 2019, rotablator and orbital atherectomy were used but the outcome wasn’t as anticipated. Shockwave lithotripsy was performed on January 5th using a 3.0mm IVL balloon and perfusion was restored. Lesion was then dilated by a 3.5mm NC balloon, afterwards two 3.5mm stents were placed along the vessel.