Percutaneous Coronary Intervention (PCI) has revolutionized the management of Coronary
Artery Disease and has become the preferred modality of revascularization in a majority of cases.
Nevertheless, situations are encountered frequently where device deliverability to coronary lesions entails
technical difficulties due to varied anatomies and lesional complexities like tortuosity, calcifications,
length of lesions and vessel morphology. While continuous technological refinements are occurring
in PCI hardware armamentarium and stent designs, a number of techniques and their modifications
and variations have evolved to increase the applicability of PCI to difficult lesions.
The present article envisages a thorough review of all aspects of improving successful device deliverability
in complex PCI with prominent emphasis on increasing the backup support of Guide
Catheters which is the primary factor of success in difficult coronary lesions.
Keywords: Percutaneous Coronary Intervention (PCI), Drug-Eluting Stents (DES), Chronic Total Occlusion (CTO), Transradial
Interventions (TRI), mother- child technique, guideliner, buddy wire, anchor balloon.
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