Guidewire lengths

Overview
The standard length of a coronary guidewire is 175-190 cm. The standard length of an exchange length coronary guidewire is 270-400 cm.

Advantages of a Short Coronary Guidewire
Shorter guidewires are easier to use and more manageable for a single operator. A short wire is often used in conjunction with a rapid exchange catheter. Rapid exchange catheters take up less space in the guiding catheter and allow for better contrast injections (and thereby allow better opacification of the coronary artery) and also allow for additional equipment to easily pass through the guiding catheter. This is often useful in the management of bifurcation lesions.

Disadvantages of a Short Coronary Guidewire
Short coronary guidewires and rapid exchange catheters do not perform as well in passing through tortuous or angulated lesions or tight lesions when compared with long wires and over the wire (OTW) systems. The operator cannot exchange for alternate devices as easily with a short wire. Once the lesion is crossed, you cannot exchange for a guidewire offering more support. As result of this, sure wires are often not use in the management of chronic total occlusions and in those cases where there is pronounced tortuosity or angulation of the lesion.

Use of a Docking Wire to Extend the Length of a Short Coronary Guidewire
If you are using a standard length wire and need to create an exchange length wire, you can use a "docking system" to mount an additional length of wire onto the standard wire. The docking wire attaches to the standard length wire. Care should be exercised as the docking joint is prone to “snapping” when bent, and the docking joint may give way.

Use of an Exchange Link Wire As Part of a Single Operator Procedure
When using an exchange length wire and delivering a balloon or a stent, a magnet may be used to hold the wire in place. It is preferable to have two operators when using an exchange length wire.

Use of a Long Coronary Guidewire
Long coronary guide wires are used in chronic total occlusions where there is a need to switch out wires, and in tortuous and angulated lesions. Over the wire systems are often used in teaching hospitals and training programs.