The LMS was engaged with a 7F XB 3.0 guiding catheter. The LAD and LCX arteries were crossed with 0.014″ guidewires, respectively. The ostial LCX was dilated with a 2.5 × 15 mm balloon at 12 atm (Fig. 19.4). With great difficulty, a 2.0 × 15 mm compliant balloon was delivered to the mid-LAD and inflated at 15 atm and again at the ostial LAD at 15 atm. The balloon failed to fully expand (Fig. 19.5). LAD blood flow dropped to TIMI 0 (Fig. 19.6) and patient immediately went pulseless electrical activity (PEA) but only requiring 1 min of cardiac massage. She quickly regained spontaneous circulation, and angiogram showed return of TIMI 2 flow in the LAD. However, in light of her hemodynamic instability and likelihood of a prolonged complex PCI, she was intubated on the table.