Crossover Buddy Wire-Assisted Delivery of Steerable Guide Catheter

Area of Science:

• Interventional Cardiology
• Medical Device Technology

Background:

• Transfemoral venous access is standard for MitraClip procedures.
• Anatomic variations, such as iliac vein compression, can impede device delivery.

Observation:

• Severe mitral regurgitation treated with MitraClip via right femoral vein access.
• Calcified right iliac artery caused significant iliac vein tortuosity, hindering steerable guide catheter advancement.

Findings:

• A crossover buddy wire technique using a Radifocus guidewire was employed.
• Successful advancement of the steerable guide catheter and MitraClip device deployment was achieved.

Implications:

• The buddy wire technique offers an adaptive strategy for challenging venous anatomy.
• This bailout approach may reduce venous injury risk during transcatheter interventions.