A 8 Fr femoral sheath (Terumo¢ç) was inserted through the right femoral artery and left coronary artery was engaged with a 8 Fr XB 3.5 guiding catheter. Each two 0.014-inch BMW 190 cm wires were inserted into LAD and LCX, respectively. Before the intervention, IVUS was used to identify lesion characteristics of LAD and LCX. Rotablation using rotablator 1.5 burr with upto 220,000 rpm was done at LM to pLAD (Figure 1). Xience Sierra stent sized 3.0 x 23 mm and 2.75 x 28 mm at denovo LM to pLCX lesion and Xience Sierra stent sized 3.5 x 33 mm and 3.0 x 33 mm at denovo LM to pLAD lesion were inserted. First, the stent at LM to pLCX was inflated (Figure 2), thereafter the stent at LM to pLAD was inflated, so the proximal strut of the former was crushed (Figure 3). Sapphire NC balloon sized 3.0 x 15 mm was used to dilate stenotic lesion of pLCX, and so was NC Trek 3.5 x 15 mm for stenotic lesion of LM to pLAD. IVUS was checked, and POT and kissing balloon were applied using Sapphire NC balloon 3.0 (15) upto 10atm (2.95) and NC Trek 3.5 (15) balloon upto 10 atm (3.42) in LM-pLCX and LM-LAD, respectively (Figure 4). The final angiogram showed no stenotic lesion and good flow ( Movie 3, Movie 4), and IVUS showed no immediate complications.
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