Two "buddies" may be better than one: use of two buddy wires to expand an underexpanded left main coronary stent.

Stent underexpansion is a catastrophic complication of stent implantation that can usually be treated with high-pressure balloon dilatation. We report a case of emergency, unprotected distal left main coronary artery stenting, in which the left main stent remained under-expanded in spite of multiple high-pressure balloon inflations, cutting balloon angioplasty, and angioplasty using one buddy wire. The stent eventually expanded after balloon angioplasty using a double buddy wire technique.