Dual-Lumen Catheter and Floating-Wire Technique to Access Protruding Aorto-Ostial Stent

PCI in the setting of previous aorto-ostial stenting can be difficult, especially if there is excessive stent protrusion. Various techniques have been described, including double-wire technique, double-guide snare technique, side-strut sequential ballooning technique, and guide extension facilitated sidestrut stenting. These techniques can sometimes be complicated, and intervention through a side-strut may lead to excessive stent deformation or avulsion of the protruding segment. Our novel technique uses a dual-lumen catheter and floating wire to back the JR4 guide away from the protruding stent while maintaining stability for another guidewire to enter the central lumen.