The mid-LAD was lesion was crossed using a Fielder wire loaded on a Finecross microcatheter. A 1.5 × 12 mm semi-compliant balloon was loaded on the wire but could not cross the lesion. Rotablation was done with no vessel pre-dilatation using a 1.5 mm burr at a speed of 170,000 from the proximal LAD to mid-LAD. Following rotablation a dissection was noted in the mid-LAD lesion resulting with hemodynamic compromise and cardiogenic shock (Fig. 7.2, Video 7.2). The patient was stabilized by inotropes and use of intra-aortic balloon counterpulsation on the contralateral femoral artery. Four bare metal stents, two 2.0 × 8 mm and two 2.25 × 8 mm, were deployed sealing the dissection with good angiographic result (Fig. 7.3, Video 7.3).