An 8 Fr sheath was inserted thorough the right femoral artery and left coronary artery was engaged with a 8 Fr JL 4 guiding catheter. First, a 0.014-inch BMW wire was inserted through diagonal branch and 0.014-inch Runthrough wire into the LAD. Balloon dilation with an Emerge 2.5 x 15 mm at the diagonal branch was done first and IVUS was done, showing ISR at diagonal branch. ( Movie 4) Then additional balloon dilatation was performed with a Raiden 3.0 x 15 mm and drug-eluting balloon was applied at the ISR lesion. (Figure 1) The next step was expanding the proximal to mid LAD lesion with a Sapphire NC 3.5 x 15 mm balloon. We implanted a Xience Alpine stent sized 3.5 x 38 mm into the LAD lesion and post-balloon dilatation was done with a Sapphire NC 4.0 x 18 mm. (Figure 2) The final kissing balloon was performed with a Sapphire NC 3.5 x 15 mm at the LAD upto 8 atm (diameter 3.39) and Raiden 3.0 x 15 mm at diagonal branch upto 8 atm (diameter 2.86). (Figure 3) The final angiogram showed a successful result. ( Movie 5, Movie 6)
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