“Kurdistan” Technique for the Treatment of Unprotected Trifurcation Left Main Stem Coronary Artery Lesion: Case Report

The left main coronary artery (LMCA) is responsible for supplying about 75% to 100% of the left ventricular cardiac mass. Left main stem coronary artery (LMCA) disease reduces flow to a large portion of the myocardium, placing the patient at high risk for life-threatening events such as left ventricular dysfunction and arrhythmias with a high mortality approaching 50% in those treated medically. For several decades, coronary artery bypass grafting (CABG) has been considered as a gold standard treatment of unprotected left main coronary artery (ULMCA). However, successful percutaneous coronary interventions (PCI) have been increasingly reported recently due to improved stent technology and better operator expertise. In spite of these factors, management can be challenging especially in LMCA bifurcational & trifurcational lesions, and therefore an integrated approach combining special techniques, physiological evaluation and adjunctive pharmacological agents should be combined for better clinical outcome. Herein, we describe a new promising technique named (Kurdistan technique) for the treatment of trifurcation unprotected left main stem lesion. In the last 18 months, 21 patients with significant trifurcational LMS had underwent PCI using this technique in our hospital (Sulaimany Heart Hospital/Kurdistan). The procedural success rate was 100%, follow up coronary angiography done between 6 12 months after the procedure for all the patients with no significant in-stent restenosis in any patient. One case is presented here demonstrating the technique.