pull back balloon assisted wiring technique for treatment of extremely angulated bifurcation lesion

Abstract We describe a clinical case of 50 -year –old man with crescendo chest pain and dyspnea, who underwent coronary angiogram showed a critical stenosis of bifurcation septal branch – LAD. Unable to access LAD due to extremely angulated take-off. The last resource technique when no other options are available is the Plaque-plowing technique, pull back balloon assisted wiring to modify the angle of bifurcation. This technique may be useful in the appropriate anatomical and clinical setting. Keywords: Bifurcation; Extremely Angulation; Plaque-Plowing Technique