Balloon Shaft–Assisted Guide Catheter Exchange Without PTCA Wire Removal

We describe a balloon shaft-assisted technique for guide catheter exchange without removing the in-situ PTCA wire. In a complex LCX in-stent restenosis case with poor guide support, a 6 Fr EBU catheter was successfully advanced over the metallic shaft of a monorail balloon tracked on a 0.014″ PTCA wire. Bench testing confirmed the shaft's ability to mimic a stiff 0.035″ wire, providing adequate support for safe catheter exchange. This technique eliminates the need for anchoring or specialized wires and offers a practical, resource-efficient solution for guide exchange, particularly in settings with limited device availability.