Proximal buddy in jail technique: A bail out technique to increase guide support

Background: During percutaneous coronary intervention, “buddy-in-jail” technique is often used to facilitate stent delivery in complex coronary artery lesions. However, the safety and efficacy of this tech­nique when used with different jailed wire and applied in different target vessel lesions remain elusive. The aim of this retrospective study was to analyze the effectiveness of “buddy-in-jail” technique in the tortuous and rigid lesions of both the common and neighboring coronary arteries. The effectiveness between hydrophilic-coated and non-hydrophilic-coated guide wire as jailed wires was also compared. Methods: The “buddy-in-jail” technique was applied in 15 patients after failed balloon or stent delivery into the target vessel lesion from June 2014 to December 2016. The safety and effectiveness of the “bud­dy-in-jail” technique was compared in the tortuous and rigid lesions of both the common and neighbor­ing coronary arteries and between hydrophilic-coated and non-hydrophilic-coated “jailed” wires. Results: Stent delivery was successful in 13 (86.7%) patients with the use of “buddy-in-jail” technique. The success rate was similar to the group using the common artery (87.5%) as a “buddy” vessel and the group using a neighboring artery (85.7%) as a “buddy” vessel (p > 0.05), and between hydrophilic- -coated (100%) and non-hydrophilic-coated “jailed” wire (77.8%) group (p > 0.05). All wires were successfully extracted without complications. Conclusions: The “buddy-in-jail” technique offers a potential alternative approach for the distal stent delivery in both the common and neighboring coronary arteries. Also, both hydrophilic and non-hydro­philic-coated wire could be safely and effectively used as “jailed” wire.