7 Fr sheaths were inserted thorough the right femoral artery. Left coronary artery was engaged with a 7 Fr XB guiding catheter. The wire, 0.014-inch Fielder XT was inserted into the LAD under backup of Corsair 2.6Fr micro guide catheter. Pre-dilation for LAD was performed with a BH PLUS 2.5 x 20 mm balloon ( Movie 6) and Pantera LEO 3.0 x 20 mm balloon ( Movie 7). Pre-dilation for diagonal branch was performed with a BH PLUS 2.5 x 20 mm balloon ( Movie 8). And then XIENCE Alpine 2.5 x 15mm was implanted at diagonal branch ( Movie 9). After stenting for diagonal branch, kissing balloon with Pantera LEO 3.0 x 20mm for LAD and Emergy NC 2.75 x 15mm for diagonal branch was done ( Movie 10). And then Absorb GT1 BVS 3.0 x 28mm, 3.5 x 28mm was deployed at proximal to mid LAD ( Movie 11, Movie 12). Additional XIENCE Alpine 4.0 x 12mm DES was implanted at proximal LAD ( Movie 13). After stenting, we performed post-dilatation with Pantera LEO 3.0 x 20mm ( Movie 14) and Nimbus Salvo 3.5 x 17mm ( Movie 15) balloon. In conclusion, two DES were implanted into side branch and ostial lesion and two DES were implanted into LAD shaft lesion. Final angiogram ( Movie 16, Figure 2) and IVUS ( Movie 17) showed that the hybrid procedure was successful.
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