- Procedural step:
An 8Fr sheath was inserted into the right femoral artery, and the left
coronary ostium was engaged with an 8Fr JL guiding catheter with 3.5cm
curve. A 0.014 inch BMW wire was inserted into the LAD, a 0.014 inch BMW
wire was inserted into the LCX and a 0.014 inch Fielder wire was inserted
into the diagonal branch. Proximal LAD and diagonal branch were predilated
with 3.0X20mm, 2.5X15mm Maverick balloon respectively. The LAD bifurcation
was treated by a mini-crushing technique. While keeping a 3.0 mm balloon
at pLAD (Figure
2), we deployed Promus 2.5X15 mm stent at the diagonal ostium. After
removal of stent balloon, the diagonal stent was crushed by a pLAD balloon.
Then, we deployed Promus 3.0 X 28 mm at pLAD. (Figure
3) After rewiring of the diagonal artery, kissing balloon technique
was done with Quantum 3.0 X 15mm, Maverick 2.0 X 15mm at pLAD and Diagonal
branch respectively. (Figure
4) IVUS showed dissection at pLAD stent distal site. (Figure
5) We performed bailout stenting with Promus 2.5 X 18mm.(Figure
6) Final left angiogram showed that the procedure was successful.(Figure
7)
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