An 8 Fr sheath was inserted through right femoral artery, and the left coronary ostium was engaged with an 8 Fr JL 3.5 catheter with side hole. Three 0.014 inch BMW wires were inserted into the LAD, and diagonal branch. We examed lesions with IVUS to make a decision. IVUS examination revealed relatively normal diagonal ostium (Figure 1). So, we intended to treat the lesions with simple cross-over technique. Predilatation was performed with a 2.5 x 20mm Maverick balloon at pLAD (Figure 2). After predilatation, Resolute Integrity stent (3.5x26mm) were implanted at dLM to pLAD (Figure 3). And then, postdilatation using a 3.5 x 15mm Empira NC balloon and 4.0 x 8mm Quantum balloon was performed. The following angiogram showed well-expanded stents, but stenosis of diagonal ostium was observed ( Movie 3). We checked diagonal FFR, which was 0.89. Therefore, we finished the procedure. Final angiogram showed that the procedure was successful ( Movie 4, Movie 5). |
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