Some percutaneous coronary interventions (PCI) may be challenging due to unsuccessful advancement of balloon across the coronary artery lesion. The reasons of this challenge may be severe coronary artery calcification, tortuosity, aortoostial lesion and insufficient back-up support of guiding catheter. To overcome this problem several techniques have been reported. These techniques include mother-child, anchor balloon and buddy wire techniques 1-3. In this case report we present a novel technique using microcatheter (MC) as buddy, which can aid to cross balloon catheter during difficult PCI cases. In conclusion, we suggest that use of buddy MC to advance the balloon across the lesion during challenging PCI is a simple, inexpensive and easily available technique.
