Bifurcation stenting. Crush technique. LAD / Diagonal

68 yr old male

1. Q3.5 8F guide. LAO cranial view. Tight main LAD stenosis with

diagonal (D) arising from the midpoint of the stenosis (arrowed).

2. PA cranial view to show lesion with additional stenosis at origin of diagonal (long arrows)

3. LAO cranial view. LAD and diagonal wired. 3.0 x 12mm balloon inflation diagonal.

4. PA cranial view. Balloon inflation LAD with same 3.0 x 12mm balloon.

5. PA cranial. Angiogram to show result of balloon only inflation in both vessels

6. LAO cranial view. Positioning stents in both vessels. 3.5 x 16 DES LAD stent longer than 3.0 x 12 DES diagonal stent and

overlaps it proximally. Diagonal stent deployed.7. PA cranial view. Diagonal wire removed. LAD stent deployed.8. Final result. Following LAD post-dilatation. LAO cranial view.

9. Final result. PA cranial view

D

LAD

L

DLCx

LAD

D

LAD

DLAD

D

LAD

D

LAD

D

LAD

D

LAD