Case report: pierced-balloon technique for navigating difficult side branch angulation in a critical left main coronary artery bifurcation disease

Dual lumen microcatheters are required to navigate angulated and diseased side branch. Many a times, they are not available.

We used an alternative inexpensive pierced-balloon technique to manoeuver coronary wire across a diseased and angulated left circumflex artery in a case of distal critical bifurcation disease of the left main coronary artery in a 57-year-old gentleman who presented with non-ST elevation myocardial infarction.

This technique can be used as an alternative to double lumen microcatheter when the latter is unavailable. It is inexpensive and a regular balloon catheter albeit of longer length needs to be used.