A temporary pacemaker was inserted into the right ventricle. The 0.014″ guidewire was next exchanged for a Roto extra-support wire. The saphenous vein graft was burred at 150,000 RPM with a 1.5 mm (Fig. 12.3) and a 2.0 mm burr (Fig. 12.4). Scoring atherotomy was performed at this stage (Figs. 12.5). Next, three overlapping 4.0 × 28 mm everolimus DES were placed in overlapping fashion (Figs. 12.6, 12.7, and 12.8). The intravascular ultrasound catheter was reinserted, showing that the stents were under-deployed in some areas, at which point a 5.0 mm noncompliant balloon was used to post-dilate the stent (Fig. 12.9). Final angiographic images were obtained showing excellent results (Fig. 12.10).