Bilateral Arm Approach for Percutaneous Coronary Intervention of Unprotected Left Main Supported by a Modified Intra-Aortic Balloon Pump

Patients in whom femoral arterial access is not feasible pose a challenge in terms of hemodynamic support during high-risk percutaneous coronary intervention. Patient's height adds another challenge given the fixed lengths of available intra-aortic balloon pumps, in terms of achieving an adequate infrasubclavian positioning in the descending thoracic aorta. We report a case where a modified intra-aortic balloon pump helped achieve a successful result in a patient undergoing intervention of an unprotected left main using bilateral arm approach.