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Wires to be used in escalating order of aggressiveness:
Wires to be used in escalating order of aggressiveness:
:* '''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]].
====First Choice====
:* '''Hydrophilic''' wires may track better after the proximal cap of the occlusion has been crossed.  Hydrophilic/coated wires have better maneuverability in [[tortuosity|tortuous]] or [[calcification|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]].
'''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]].
:* Shaping the wire tip using a modest angulation is better for blunted stump occlusions.
====Second Choice====
:* A low-profile balloon or exchange catheter adds back-up support for wire penetration of fibro-calcific caps and may also be used cautiously for balloon-assisted progression within the occlusion.
'''Hydrophilic''' wires may track better after the proximal cap of the occlusion has been crossed.  Hydrophilic/coated wires have better maneuverability in [[tortuosity|tortuous]] or [[calcification|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]].
:*  Intra-luminal position of the wire distal to the occlusion is suggested by a freely rotating wire tip or angiography in different views by distal catheter or contralateral injections.
====Third Choice====
:* Stiffer wire tips will allow for a greater chance of crossing the proximal cap of the occlusion at the cost of an increased risk of vessel [[dissection]] or [[perforation]].
'''Stiff non-hydrophilic wires''': The [[Miracle Bros]] 6, 9 and 12, [[Cross-IT]], [[Confienza]], [[Persuader]]
::* '''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]]
'''Stiff and hydrophilic (most aggressive)''': [[Pilot 200]] and [[Shinobi]]


[[Guidewire cross it series|Cross it Series]] | [[Guidewire miracle bros series|Miracle bros series]] | [[Guidewire shinobi|Shinobi]] | [[Guidewire confianza|Confianza]]
[[Guidewire cross it series|Cross it Series]] | [[Guidewire miracle bros series|Miracle bros series]] | [[Guidewire shinobi|Shinobi]] | [[Guidewire confianza|Confianza]]

Revision as of 23:39, 23 October 2011

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List of terms related to Guidewire

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Priyantha Ranaweera [2];

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

Overview

Historical Perspective

Guidewire techniques

Desirable Performance Characteristics of Coronary Guidewires

Guidewire Complications

Steering the Guidewire

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

List of Guidewires by Manufacturer

Guidewires Classified Based Upon Support (Steerability and Trackability)

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

Guidewires Classified By Crossing Profile

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

Cross it Series | Miracle bros series | Shinobi | Confianza

Device Delivery Guidewires

Stabilizer | Wiggle wire

Peripheral Arterial Guidewires

Spartacore | V 18


References


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