Successful use of a balloon catheter to facilitate guidewire placement in an occluded coronary artery with extreme angulations.

The present report describes the case of a 77-year-old man with unstable angina, in which the culprit vessel was extremely angulated and precluded placement of a guidewire for subsequent coronary interventions. A novel technique is reported, using an undersized, uninflated and distally placed balloon catheter, which easily facilitated guidewire placement.