Double-v side-branch stenting followed by main trunk stenting in type-a3 trifurcation coronary artery disease using a dual-catheter technique - the triple-tine fork technique.

We report on a 55-year-old male patient who presented with acute non-ST elevation inferolateral myocardial infarction. He underwent conventional coronary angiography 3 days after admission that revealed normal right coronary artery, 30% plaque in midleft anterior descending artery as well as total proximal left circumflex artery occlusion, which proved to be a type-A3 trifurcation lesion after predilatation. The trifurcation was approached with triple wiring and tackled with a novel 4-stent strategy that predicates at first the distal two side branches and the distal main branch (MB) stenting using dual 6 and 7 Fr guiding catheters that were introduced via a bifemoral approach, followed by main trunk (proximal main vessel) stenting with final trissing-balloon inflation. Angiography at the end of the procedure revealed a triple-tine fork-like shape. There was no postprocedural pain or CPK leakage. One year later, the patient was free from any cardiac complaints.