The Perils of Buddy Wire Use With a Filterwire.

Embolic protection devices may decrease the risk of distal embolization during percutaneous coronary intervention of saphenous vein graft and highly thrombotic lesions. Use of a buddy wire can facilitate equipment delivery but carries perils when used together with a filter. We present two cases demonstrating potential complications of buddy wire use with a filter. In the first case a saphenous vein graft perforation occurred after stenting. A buddy wire and second balloon were used to maintain hemostasis while removing the Filterwire. The buddy wire, however, was caught in the filter retrieval catheter, interlocking the two guide catheters and was eventually removed after forceful pulling. In the second case a Filterwire was used to prevent distal embolization of a highly thrombotic right coronary artery lesion. A buddy wire was used to assist with equipment delivery. A stent was inadvertedly deployed over the buddy wire, entrapping the Filterwire. The entrapped Filterwire was eventually removed after multiple balloon inflations over the buddy wire.