One of the most challenging aspects of PCI is managing calcified lesions, particularly in patients with a history of coronary artery bypass grafting, chronic kidney disease, or diabetes. Before stent deployment, vessel preparation using dedicated equipment—guided by intracoronary imaging findings—is essential. Intracoronary imaging should be readily available in every catheterization lab, as stent under-expansion is an independent predictor of myocardial infarction, target lesion revascularization, and mortality.