Alcohol septal ablation is widely accepted as a therapeutic option for the treatment of hypertrophic obstructive cardiomyopahty. The selection of an appropriate target vessel is key for an effective and safe procedure. The target vessel sometimes bifurcates from the non-left anterior descending coronary artery, in which case these vessels are sometimes difficult to select with a wire and deliver a balloon catheter. The combined use of a microcatheter and a balloon catheter is one of the choices for treatment of patients with this type of challenging anatomy. © 2015 Wiley Periodicals, Inc.