A percutaneous wire-guided double lumen intraaortic balloon pump was tested in 44 patients, 15 with cardiogenic shock. The balloon volume is 40 ml, the material is Avcothane, and the central lumen will pass a 0.035 inch (0.889 mm) wire guide. Standard Seldinger technique was followed by successful insertion in 40 patients (90 percent) with no recognized vascular trauma. Counterpulsation was excellent and central pressure monitoring through the balloon lumen showed good fidelity. Iliofemoral thrombosis occurred in 5 percent of patients. The overguide technique is simple, successful and atraumatic.