EBC - ON DEMAND
Jailed wire – rationale
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