Proximal buddy in jail technique: A bail out technique to increase guide support

Abstract

Background: During percutaneous coronary intervention, “buddy-in-jail” technique is often used to facilitate stent delivery in complex coronary artery lesions. However, the safety and efficacy of this technique when used with different jailed wire and applied in different target vessel lesions remain elusive. The aim of this retrospective study was to analyze the effectiveness of “buddy-in-jail” technique in the tortuous and rigid lesions of both the common and neighboring coronary arteries. The effectiveness between hydrophilic-coated and non-hydrophilic-coated guide wire as jailed wires was also compared. Methods: The “buddy-in-jail” technique was applied in 15 patients after failed balloon or stent delivery into the target vessel lesion from June 2014 to December 2016. The safety and effectiveness of the “bud-dy-in-jail” technique was compared in the tortuous and rigid lesions of both the common and neighboring coronary arteries and between hydrophilic-coated and non-hydrophilic-coated “jailed” wires. Results: Stent delivery was successful in 13 (86.7%) patients with the use of “buddy-in-jail” technique. The success rate was similar to the group using the common artery (87.5%) as a “buddy” vessel and the group using a neighboring artery (85.7%) as a “buddy” vessel (p > 0.05), and between hydrophilic--coated (100%) and non-hydrophilic-coated “jailed” wire (77.8%) group (p > 0.05). All wires were successfully extracted without complications. Conclusions: The “buddy-in-jail” technique offers a potential alternative approach for the distal stent delivery in both the common and neighboring coronary arteries. Also, both hydrophilic and non-hydrophilic-coated wire could be safely and effectively used as “jailed” wire.