Usefulness of buddy-wire anchoring technique in cases where deep insertion of guide extension catheter is difficult

Guide extension catheters are useful in PCI procedures when device passage is difficult. However, in complex lesions, such as severely tortuous vessels, deep insertion of the guide extension catheter cannot always be achieved even when balloon anchoring technique is applied. In such cases, in our hospital, a guidewire is added as a buddy wire and the balloon anchoring technique is applied. The advantage of this method is that the anchoring force is strengthened by anchoring another wire with the wire. By pulling the wire that has been anchored with a balloon, anchoring force is fortified, enabling deep insertion of the guide extension catheter and subsequent stent delivery. This method, which we refer to as the Buddy-wire anchoring technique, can be useful in cases of complex lesions, especially those with severely tortuous vessels, where device passage is difficult. Here we report on the Buddy-wire anchoring technique (Fig. 1). Fig. 1 a Cine image showing Buddy-wire anchoring technique. The black arrow indicated the tip of the guide extension catheter. The red arrow indicated the balloon which anchoring the wire. b Schema showing Buddy-wire anchoring technique.