Use of the twin-pass catheter for wiring a jailed side branch

Wiring through stent struts into a jailed side branch can be challenging. We describe a case of double-barrel left main coronary artery stenting into the first obtuse marginal branch that resulted in significant ostial circumflex coronary artery stenosis. We were unable to wire the jailed large distal circumflex artery. We introduced the Twin-Pass catheter over the first obtuse marginal wire, placing the proximal lumen tip over the distal circumflex ostium. The distal circumflex artery was successfully wired, allowing balloon dilatation and successful completion of the case.