title: Treatment of a double-bifurcation lesion with sirolimus-eluting stents using the "sleeve technique".
abstract: We describe a diabetic patient with a very long lesion in a small and diffusely diseased left anterior descending artery that had 2 sizable and diseased diagonal branches (double-bifurcation lesion). The authors successfully used sirolimus-eluting stents and the sleeve technique to reconstruct the vessel and its 2 bifurcations. The sleeve technique is a modified version of the crush technique. It involves stent placement in the side branch ostium, balloon-crush of the proximal protruding stent segment against the main vessel wall, and reconstruction of the side branch ostium by kissing balloon inflation, followed by stenting of the main vessel and reconstruction of the bifurcation again by a second kissing balloon inflation.
authors.affiliation: Queen Mary Hospital, Department of Medicine, Pokfulam Road, Hong Kong. jimmanh2002@yahoo.com
authors.forename: Man-Hong
authors.initials: MH
authors.lastname: Jim
authors.forename: Hee-Hwa
authors.initials: HH
authors.lastname: Ho
authors.forename: Wing-Hing
authors.initials: WH
authors.lastname: Chow
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D017023:Coronary Angiography; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018570:Risk Assessment; D012720:Severity of Illness Index; D020123:Sirolimus / Q000627:therapeutic use; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency
chemical_list: D020123:Sirolimus