Balloon-Assisted Stabilization Technique for Accurate Stent Deployment in Hypermobile Coronary Segments

Precise stent placement during percutaneous coronary intervention (PCI) can be challenging in highly mobile coronary segments, where conventional adjunctive techniques may fail to provide adequate stabilization. We report two cases illustrating a simple and effective balloon-assisted stabilization technique for optimal stent deployment in hypermobile coronary arteries. In the first case, excessive vessel motion during PCI of the ramus intermedius resulted in proximal stent migration into the left main coronary artery, necessitating retrieval. In the second case, marked mobility of an obtuse marginal branch hindered accurate stent positioning. In both patients, a secondary semi-compliant balloon was advanced alongside or proximal to the target lesion and inflated at low pressure (3–4 atm) to stabilize the vessel. This maneuver eliminated target motion, enabling precise angiographic positioning and successful stent deployment without complications. Balloon-assisted stabilization provides a simple, reproducible, and cost-effective method for facilitating accurate stent delivery. Unlike traditional anchor or buddy-wire techniques, it directly immobilizes the target vessel, thereby minimizing the risk of geographic miss or stent migration. The technique may be particularly valuable when hypermobility, defined as visible or apparent vessel oscillation exceeding 2 mm during the cardiac cycle, persists despite conventional support strategies.

Keywords: Balloon-assisted stabilization, coronary stent deployment, hypermobile coronary, percutaneous coronary intervention, stent migration.