Emergent coronary artery bypass surgery for failed percutaneous coronary intervention (PCI) during acute myocardial infarction (MI) is a bailout strategy that is associated with a high in-hospital morbidity and mortality (7–10%). Innovative strategies to improve the probability of PCI success in this setting are needed. Antegrade coronary re-entry with the Stingray™ balloon and guidewire has been shown to facilitate recanalization of chronic total occlusions in stable patients. We report a case where the Stingray™ device was successfully used as a bailout strategy in the setting of an acute MI complicated by cardiogenic shock. © 2013 Wiley Periodicals, Inc.