Distal anchoring balloon technique performed by a 6 Fr radial approach is described in detail, in a very didactic manner in the setting of stent delivery failure, in complex anatomical scenarios.

Three cases are illustrated, in which distal anchoring allowed to advance a stent to the target lesion.

The peculiarity of the present cases is that all have been performed by 6 Fr radial approach.

A distinctive feature is the description of the “train maneuver” to fully utilize the inner lumen of the 6 Fr guiding catheter.