Fig. 2

Coronary angiography. Initial angiography showed a focal stenosis of ostial LAD and a diffuse stenosis of high lateral branch of LCx (a, b). After the first percutaneous coronary intervention (PCI) by directional coronary atherectomy and paclitaxel-coated balloon (c, d). Five months later, a restenosis of the ostial LAD and progressed stenosis of LMCA and ostial LCx emerged (e, f). After the second PCI by directional coronary atherectomy and paclitaxel-coated balloon (g, h, i). At six months after the second PCI, restenosis of distal LMCA and ostial LCx, and diffuse stenotic progressions of the mid LAD and LCx were observed (j, k, l); coronary artery bypass graft was therefore performed. LAD: left ascending coronary artery, LCx: left circumflex coronary artery, LMCA: left main coronary artery, PCI: percutaneous coronary intervention