The 5.0 French Palmaz-Schatz stent delivery system is a relatively bulky, stiff system which can be advanced only over a 0.014" wire. Although crossing failure is rare, advancement of the delivery system through tortuous, rigid vessels may be unsuccessful. We report on four consecutive cases in which the initial advancement of the Palmaz-Schatz stent delivery system was unsuccessful due to vessel tortuosity or vessel angulation. The use of a 0.018" stiff wirer adjacent to the Palmaz-Schatz delivery system, to "straighten" the vessels and to give additional guide catheter support, allowed for the successful advancement and delivery of coronary stents in all four cases.
