The Simmons-lock technique: a simple solution for stable left gastric artery engagement

Catheterization of the left gastric artery (LGA) is often challenging due to acute angulations that compromise catheter stability. We describe the Simmons (SIM)-lock technique, a novel approach using a standard 5-Fr SIM-1 catheter and a coaxial microcatheter. The microcatheter is first advanced into a distal branch to serve as an anchor, allowing the SIM1 catheter to be deep-seated within the celiac trunk. Upon removal of the microcatheter, the SIM1 catheter assumes its functional recurved shape, with the tip oriented cranially. A controlled pullback maneuver then causes the free tip to slide and lock securely into the LGA ostium. This method transforms a typically unstable engagement into a controlled, stepwise procedure, providing a stable platform for intervention while utilizing standard, cost-effective equipment.