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Coronary trifurcation lesions are a complex group of lesions. Percutaneous intervention of such trifurcation lesions which involve left anterior descending artery, left circumflex artery and RAMUS artery is difficult task. Trifurcating coronary artery disease is a complex atherosclerotic process involving the origin of one or more of three side branches arising from a main trunk. The approach to treat trifurcation lesions has not been standardized. We describe a technique to percutaneously treat this lesion using routine day-to-day hardware and a unique two guide catheter technique. We present a case admitted in our hospital with unstable angina. CAG done suggestive of triple vessel disease and later PTCA was done. Staged PTCA was planned Initially RCA and subsequently Trifurcation PTCA was done for left system.No postprocedural complication was observed and then patient was discharged on third day.

Chronic mesenteric ischemia (intestinal angina) is a condition that is caused by stenosis or occlusion of the mesenteric arteries (Superior mesenteric artery, inferior mesenteric artery and celiac artery) and usually manifest as abdominal pain which is usually post - prandial in nature. If plaque or lesion in an artery supplying the intestines narrows the vessel so severely that sluggish blood flow causes a clot, blood flow through that artery can become completely blocked, which can lead to ischemia .While surgical revascularization has been the standard treatment for symptomatic patients in past , recent advances in interventional devices and techniques have made endovascular treatment easily available and effective treatment. Endovascular treatment is considered as minimally invasive means of obtaining good long-term results. The Coronary arteries are common hiding places for cholesterol-filled plaque and blood clots. Plaque can limit blood flow during exercise or stress, causing the chest pain or pressure known as angina. Clots may completely block blood flow, causing a heart attack or cardiac arrest. These two leading perpetrators can do similar things elsewhere in the body. When they interfere with blood flow to the digestive system, the effects can range from a stomach ache after every meal to a life threatening emergency. We report a similar case who present with unstable angina. During hospitalization he was having persistent abdominal pain and who was investigated with CT abdomen and later Angioplasty was done which further showed significant benefit to patient.

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