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During our day-to-day work in catheterization lab, we encounter several problems. They may range from something simple like “wire crossing but balloon not crossing” to something more drastic such as “migration of thrombus in left main”. Unfortunately, anybody who really has a significant volume of percutaneous coronary intervention (PCI) has faced this scenario (however skilled he/ she may be). But, still there is a tendency to brush really serious complications like mortality under the carpet. On the other hand, these are the very cases where there is a maximum opportunity to learn. Further, there may be several alternate strategies to tackle these practical problems but they are not discussed in any book since there are no randomized controlled trials (RCTs) in this area. <br/>In this manual, author had discussed threadbare what went wrong (whether it was a wrong selection of case, wrong selection of hardware or technique), where exactly did it go wrong and finally what corrective steps were undertaken so that the situation could be salvaged. We feel that in this area, where no RCTs are available the best way to learn is by errors and tribulations of others and by building a mental library of the cases, so that one is prepared when a similar situation arises.
