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Catheter Cardiovasc Interv. 2019 Feb 15;93(3):436-439. doi: 10.1002/ccd.27873. Epub 2018 Sep 23.

Buddy-wire technique during rotational Atherectomy: Simple and effective solution to achieve strong back-up support.

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Unit of Cardiovascular Interventions, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Department of Cardiology, Vita-Salute San Raffaele University, Milan, Italy.
Department of Cardiology, Hammersmith Hospital, Imperial College NHS Healthcare Trust, London, United Kingdom.


A 52-year-old male underwent percutaneous coronary intervention (PCI) using rotational atherectomy (RA: 1.5-mm burr) for a severely calcified lesion in the proximal to mid obtuse marginal (OM) branch. Even with 7 Fr extra back-up guiding catheter via femoral access, the burr could not cross the lesion due to insufficient back-up support. In order to achieve stronger back-up support, we kept the burr at the position in the OM branch and placed a supportive wire in left anterior descending artery through the side of drive-shaft sheath of the Rotablator, which sufficiently stabilized the guiding catheter during the ablation and the burr crossed the lesion. This case demonstrates that a simple technique of placing additional supportive wire in the other vessel during RA could be an effective and safe solution to facilitate improved back-up support without necessity to change the PCI system used already.


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