An 84-year-old man on hemodialysis underwent percutaneous coronary intervention for his heavily calcified stenosis of the diagonal branch causing acute coronary syndrome ( Fig. 1 A; Video 1 ). Despite a high-pressure dilation with a noncompliant balloon ( NC Kamui 2.5 × 15 mm, Asahi Intecc) at 26 atm, above the rated burst pressure of 20 atm, the lesion could not be expanded ( Fig. 1 B). When retracting the balloon, the distal portion of the balloon was trapped and fractured by the heavily calcified plaque ( Fig. 1 C). The connection between the balloon and the distal shaft of the catheter was broken, and the distal portion of the balloon and inner coil remained in place with the guidewire ( Fig. 1 D, E). After an additional guidewire insertion ( Video 2 ), an intravascular ultrasound showed the remaining balloon fragment at the distal end of the calcified plaque ( Fig. 1 a, b; Video 3 ). Because the distal balloon marker remained on the guidewire and was visible on X-ray, we could capture it by Goose Neck Snare (Medtronic; Fig. 1 F; Video 4 ). However, the radiolucent balloon tip could not be obtained. A 2.5 × 20 mm drug-coated balloon ( Agent , Boston Scientific) was applied instead of stent implantation ( Video 5 ).