A simple method preventing tangling of the guidewires during percutaneous coronary intervention for bifurcation lesions

The aim was to examine the efficacy of the simple technique that reduces tangling of the guidewires by utilizing wet gauze during percutaneous coronary intervention with multiple guidewires. We defined "Critical tangle of the guidewires" as occurring when it became impossible to insert balloon catheters into the bifurcation lesion due to tangling of the guidewires without withdrawing and reinserting one of the guidewires. We compared the rate of the critical tangle of the guidewires between the group taking no special tangle precaution ("NP Group"), and the group taking the tangle precaution with the wet gauze ("Gauze Group"). Eighty-four patients were enrolled in the study and randomly assigned to either NP Group (n = 43) or Gauze Group (n = 41). The kissing balloon technique success was 42/43 (97. 7%) versus 40/41 (97.6%), in NP Group and Gauze Group, respectively. The rate of critical tangle of the guidewires was significantly lower in Gauze Group (27. 9 vs. 7.3%, p = 0.014). The manipulation of several guidewires utilizing gauze method will be a useful technique for reducing tangle of the guidewires during the procedure of kissing balloon technique. © 2011 Japanese Association of Cardiovascular Intervention and Therapeutics.