Seesaw double GuideLiner catheter technique for a successful bail-out procedure from blow-out type coronary perforation.

We encountered a case of blow-out type coronary perforation at the calcified stenosis of left anterior descending artery. First, we started immediate balloon tamponade through the initial guiding catheter (GC) with a GuideLiner catheter. Next, we introduced a second GC with a GuideLiner catheter and successfully deployed a covered stent. Two sets of the GC with GuideLiner catheter facilitated us to simultaneously perform temporary hemostasis with balloon tamponade and rapid delivery of a covered stent. To alternately manipulate the GuideLiner catheters, back and forth with seesaw-like motion enabled us to minimize the interruption of balloon tamponade.