Guidewire


 * Associate Editor-In-Chief: Priyantha Ranaweera [mailto:pranawee@bidmc.harvard.edu];

Key Words and Synonyms: PCI guidewire, angioplasty guidewire, coronary guidewire, steerable wire, steerable guidewire

Guidewire Techniques
General guidewire techniques | Guidewire Techniques to Cross a Chronic Total Occlusion | Guidewire Techniques to Cross an Angulated Lesion or Tortuous Vessel Segment

Guidewire Design Features
A guidewrie has three main components - a Core, a Tip and a Lubricous Coating.



Figure : Components of a guide wire (courtesy : Abbott vascular inc)

Guidewire core | Guidewire coatings | Guidewire tip

Guidewire core diameters | Guidewire tip diameters | Guidewire lengths

Soft Guidewires
Asahi soft guidewire | Hi-torque balance

Moderate Support Guidewires
Wisper wire | Wisdom | High torque balance middle weight

Extra Support Guidewires
Choice PT extra support | PT Graphix Intermediate | Stabilizer | Hi-Torque balance heavy weight

Super Extra Support Guidewires
Iron Man | Asahi Grand Slam

Complex lesions and lesions in very tortuous vessels
Prowater | Choice PT | PT graphix intermediate

Guidewires Used to Cross Chronic Total Occlusions
Crossing Chronic Total Occlusions

Wires to be used in escalating order of aggressiveness:

First Choice
Non-hydrophilic or hydrophobic wires with an intermediate stiffness are a good first choice as they have a better tactile response, are less likely to lead to a subintimal position than a hydrophilic wire, and may have an additional advantage in their ability to cross the proximal cap of the occlusion. Choices in this class include the Miracle Bros 3 and the Asahi intermediate wires.

Second Choice
Hydrophilic wires may track better after the proximal cap of the occlusion has been crossed. Hydrophilic/coated wires have better maneuverability in tortuous or calcified vessels. Intermediate stiffness hydrophilic wire choices include the Choice PT XS (Extra Support), the Pilot 50, the Pilot 100 or the PT Graphix intermediate wire.

Third Choice
Stiff non-hydrophilic wires: The Miracle Bros 6, 9 and 12, Cross-IT, Confienza, Persuader

Fourth Choice
Stiff and hydrophilic (most aggressive): Pilot 200 and Shinobi

Device Delivery Guidewires
Stabilizer | Wiggle wire

Peripheral Arterial Guidewires
Spartacore | V 18