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Jailed wire – rationale

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European Bifurcation Club 2006 – EBC 2006 – Rome, Italy

Very simple, simple or complex approach ?, Part I

Jailed wire – rationale

Author: F-X Kleber, Germany

 

ADVANTAGE OF JAILING

Insertion of 2nd wire

  • widenes bifurcation angle,esp. in T-shaped bifurcations, facilitates access
  • preserves side branch patency by opening a slit like access
  • permits side branch ostium location in case of occlusion after main branch stenting

COMPLICATIONS

  • distal wire rupture
  • deep guiding catheter engagement during retraction of jailed wire

CONCLUSION

  • Jailed wire technique is necessary only in a minority of interventions
  • Several techniques are available that offer similar success rates as the jailed wire technique, including:
    • kissing predilatation
    • crush technique
    • kissing stent technique
    • highly flexible thin strut stents
  • High end BMS allow an easy approach with similar results as compared to complex procedures
  • most DES are still unsatisfying in terms of stent design esp. strut thickness, flexibility and distal distortion during side branch access, but offer a somewhat lower restenosis rate
  • Complex techniques in most DES are still mandatory for important side branches

 

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