Patients with previous coronary artery bypass grafting and advanced chronic kidney disease (CKD) are considered high risk for revascularization. In addition to native coronary artery angiography, additional contrast is required to visualize the bypass conduits, increasing the risk of contrast-induced nephropathy (CIN) and need for renal replacement therapy. As a result, despite the need for revascularization, these patients are frequently under-treated.1