Trifurcation Stenting of left anterior descending artery by “Kurdistan” Technique using Two Guide Catheters

Abstract

Percutaneous coronary intervention of trifurcating lesion is a challenging and complex procedure. This has been reported for left main trifurcation disease but little is known about such substrate in left anterior descending artery. We herein report a case of 68-year-old male with chronic stable angina who was successfully treated with percutaneous coronary stent implantation for trifurcation lesion of left anterior descending artery. Bifurcation lesion was treated using culottes' technique with 6F guide catheter. Balloon angioplasty of third side branch of the trifurcation lesion was performed with another 6F guide catheter. Here, first 6F catheter was pulled to dehook the left main when left main was being hooked with second 6F catheter. Fine tuning of both guide catheters needs to be exercised to make them stable, and to avoid injury of left main artery. This is the first case report to highlight the feasibility and efficacy of dual guiding catheter to treat a trifurcation lesion of left anterior descending artery by "Kurdistan" Technique.