At SCAI 2023 PHOENIX, Dr. Sarita Rao, Sr. Interventional Cardiologist at Apolo Hospitals Indore, conducted a remarkable LIVE CASE TRANSMISSION featuring Ultra low contrast PCI in an elderly gentleman with CKD, severe LV dysfunction, LEFT MAIN Bifurcation, and RCA CTO. The procedure was supported by IMPELLA and guided by IVUS for a Minicrush technique. The discussion and results were highly commendable, with upfront IMPELLA support yielding excellent outcomes.