Novel Application of the Jailed Balloon Anchor Technique to Improve Guiding Catheter Stability During Intravascular Ultrasound Guided Ostial Coronary Stenting

Precise stent positioning during percutaneous coronary intervention (PCI) for coronary ostial lesions is technically important but often challenging. During ostial stenting, the guiding catheter (GC) frequently requires slight disengagement from the coronary ostium, which may result in catheter instability caused by cardiac motion and respiratory fluctuation. Such instability can interfere with reliable intravascular ultrasound (IVUS)-guided landmark recognition and controlled stent deployment. Although accurate stent placement at the coronary ostium is clinically important, few practical strategies specifically address GC instability during IVUS-guided ostial PCI. We describe a modified jailed balloon anchor technique (JBAT) used to stabilize the GC during IVUS-guided ostial stenting. In this technique, a small balloon positioned in a side branch is gently inflated at low pressure to function as an anchor, thereby mechanically coupling the GC and coronary artery and reducing relative displacement during cardiac motion. This maneuver facilitated stable IVUS landmark recognition and controlled stent positioning in a case with substantial catheter movement.