The 67 year old female was presented with resting chest pain for 2 weeks. Baseline coronary angiogram showed a tight stenosis in the left main coronary artery (LMCA) with intermediate lesions in the left anterior descending (LAD) and circumflex arteries (Figure 1). We intended to treat only the LMCA lesion without covering the LAD and circumflex lesions. In this case, the coronary artery was very tortuous and heavily calcified. Moreover, the guiding catheter support was not good. An Asahi Neo¡¯s soft wire (Asahi Intecc Co, Japan) was advanced well into the circumflex artery (Figure 2-1, Figure 2-2). The wire has good trackability, suitable for such a complex case. Through the wire, IVUS examination was easily performed. After cutting balloon angioplasty, the wire in the circumflex artery was withdrawn to prevent wire trapping in the LMCA. Then, a 3.5 x 18 mm Cypher stent was deployed in LMCA lesion (Figure 3). Final angiogram showed a very good result (Figure 4).

From this case, we realized that the selection of a suitable guide wire is very important to perform complex procedure, especially in severely tortuous and calcified lesions. The Asahi Neo¡¯s Soft wire may be a good selection.