An 8 Fr sheath was inserted through right femoral artery, and the left coronary artery ostium was engaged with an 8 Fr XB 3.0 catheter with side hole. Initially, we inserted a BMW 0.014-inch 190cm guidewire into LAD- septal branch (Figure 1). Because of severe angulation of LAD , IVUS catheter could not be inserted to evaluation of lesion(Figure 2). Then, we tried to insert guide –wire into LAD with Fielder FC 0.014 inch 175cm guide wire with a Corsair¢ç 0.014 inch 2.6 Fr – 150 cm microcatheter. We failed several times for guide wire to pass into the LAD. Finally, by using anchoring with Amadeus 2.5-15mm, 0.014 inch Fielder FC 180cm guide was inserted LAD (Figure 3). After that, wire was exchanged to 0.014 BMW guide wire(Figure 4). Predilatation was performed with a 1.5 x 15mm IKAZUCHI balloon at pLAD(Figure 5). After IVUS examination and predilatation with Amadeus 2.5x 15mm(Figure 6), two drug eluting stents were deployed (XIENCE PRIME 2.5 x 38 mm at mLAD, XIENCE prime 3.5 x 28 mm at pmLAD)(Figure 7). After IVUS examination, post-stenting adjunctive balloon dilatation was done by using a 3.0 x 17mm Nimbus Salvo balloon(Figure 8). The following coronary angiogram showed well-expanded ( Movie 4). |
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