# The Buddy-Wire Technique for Impella RP Placement: A Case Report

## TL;DR

A case report describes using the buddy-wire technique to successfully place an Impella RP in a patient with a complex cardiac setup.

## Contribution

The paper introduces the rare use of the buddy-wire technique for Impella RP placement in complex cardiac cases.

## Key findings

- The buddy-wire technique helped overcome challenges posed by a defibrillator lead during Impella RP placement.
- This method may be a viable solution for patients with complex cardiac anatomies.
- The case highlights a successful alternative approach for difficult Impella RP implantation.

## Abstract

Although Impella RP has long been used in acute right ventricular failure, the use of parallel stiff and soft wires (“buddy-wire” technique) for its placement has rarely been described. A 70-year-old man with a left ventricular assist device was found to be in a ventricular tachycardia storm following a firing of his defibrillator. Due to unsuccessful cardioversion, he underwent implantation of an Impella RP. The latter was proven challenging due to the presence of a defibrillator lead; however, the implementation of the buddy-wire technique facilitated its passage, rendering it as a potential solution for patients with complex cardiac anatomies.