Rotational atherectomy is an effective transcatheter therapy for calcified coronary lesions. In large (> 3-mm) calcified coronary arteries, stent implantation following rotational atherectomy may further improve acute and especially, long-term benefit. To determine the safety and efficacy of this device synergy approach, we studied 24 consecutive patients undergoing this procedure electively in native coronary arteries. Procedural success was achieved in 100% without any major ischemic complications. There was also no incidence of subacute thrombosis or cardiac event during 30-day follow-up period. Thus, we conclude that elective stent implantation following rotational atherectomy in large, calcified coronary arteries is safe and results in excellent clinical benefit up to 30 days.