Entanglement due to Delayed Removal of a Buddy Wire

Figure 1

(a) and (b) Angiogram showing severe coronary artery disease with significant stenosis of the distal left main artery (LM) and the proximal left circumflex (LCx) (white arrows). (c) Mini-crush stenting was planned with one wire in the LAD and 2 wires including the buddy wire in the LCx. Advancement of the second stent into the LAD leads to entrapment and distortion of this stent by the buddy wire after successful positioning of the first stent into the LCx. (d) Provisional stenting of the LM-LCx lesion showed a good final result. (e) and (f) Attempts to pull the LCx “buddy wire” failed directly after advancement and before expansion of stents. Forced pullback of the buddy wire tore the LAD stent catheter tip off the shaft, blocking the mid-part of the 7F Guiding.

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