This report is a description, based on four cases, of a variation from previously described approaches for accomplishing the "kissing balloon" technique for complex PTCA. We describe a case in which a single guiding catheter is utilized in combination with two over-the-wire monorail type balloon catheters allowing use of standard length (175 cm) guidewires. Various combinations of balloon diameters are described. We believe this approach has significant advantages over other techniques, principally in its rapid and easy usage.