[Combining stenting with the double wire technique effectively prevents side branch occlusion]

Coronary angioplasty involves a high occlusive risk for side branches originating just before, within or behind the dilated stenosis. We retrospectively investigated a new technique combining stenting of the main vessel with protection of the side branch with an inserted second wire, placed between the stent and the wall of the main vessel. From 86 patients undergoing this procedure in our hospital, the side branch remained open in 78 patients (91%). Eight patients initially had a relevant partial or complete occlusion of the protected side branch after stenting. In 5 of these patients, the occlusion could be re-opened at once by angioplasty. In the other 3, TIMI flow was 1 or 2 in the side branch. One of these patients developed an additional thrombotic occlusion of the main vessel (RCA) causing Q-wave infarction. In one other patient, the side branch occlusion caused a mild elevation of creatin kinase. In summary, combining the double wire technique with stenting is safe and effective to protect side branches during coronary angioplasty.