Techniques for passing the PercuSurge Guardwire system through severe and tortuous stenotic lesions

Distal embolism is one of the major causes of morbidity and mortality associated with treating stenotic lesions by endovascular procedures, such as percutaneous angioplasty and stenting. Many devices have been designed and used to prevent this complication. The PercuSurge Guardwire system is recognized as the best system available to prevent distal embolism during stenting. However, this system is sometimes hard to pass through severe stenotic, tortuous lesions because of the poor selectivity and support. The PercuSurge device was safely introduced into two cases of severe stenotic and tortuous lesions with a triple coaxial system and the buddy wire technique, and stenting was performed successfully. These techniques are very helpful for introducing and maintaining this system in the correct position across stenoses with unfavorable configurations.