67 year old woman (#COVID19 negative) presented to Detroit Medical Center with chest pain nausea and vomiting for several days. EKG showed inferior STEMI. angiogram revealed heavy proximal thrombus that was not easy to cross with workhorse wires. Eventually crossed with Teleport (CSI360) and FielderXT (Anahi) using AL0.75 6Fr guiding catheter. IVUS confirmed the size of 4.2 mm vessel and stented with 4.0x33 mm Xience Sierra (Abbott) DES and post dilatation with 4.5x20 NC. Patient did well and discharged in 2 days.