Guidewire tip
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Characterizing the This Physical Characteristics of a Coronary Guidewire Using the Tip Load
One way of quantifying some of these physical features is by measuring with a strain gauge, the force needed to bend a wire when exerted on a straight guide wire tip, at 1 cm from the tip. Using this method, the tip loads in ascending order are 3gm, 4.5 gm, 6gm, 9 gm and 12 gm (ultra stiff). As stiffness increases the wire becomes prone to perforation
TIP OF THE INNER CORE WIRE
CORE TO TIP GUIDE WIRES
When the core is extended to the tip, that increases pushability, precise steering, tip control and torquability. This can be a useful feature for eg. in probing chronic total occlusions.
With unibody wires there is more torquability, pushability and tactile feel. With two piece tip wires shaping is easy and the wire is likely to retain the shape “wire memory”
SHAPING RIBBON
Softer tip allowing shape retention
TIP OF THE GUIDE WIRE
SPRING COIL TIP
1. Spring coil - Safer than hydrophilic coated or polymer tip wires - less risk of perforation
2. Distal weld
SPRING COILS
- Outer coils only
- Tip coil only
TIP COVER
- Polymer or plastic
- Provide lubricity
- Smooth tracking through tortuosity
POLYMER TIP (COVER)
Polymer instead of the spring coil with hydrophilic coating
Improved trackability with the compromise of reduced tactile feedback / feel
Eg: PT Graphix™ Intermediate Guide Wire, ChoICE PT wire
”COMBINATION” TIPS
- Tip coils plus
- Intermediate coils
- Bare core
- Plastic cover
- Polymer
- Polymer over tip coils
As lubricity increases the amount of tactile feedback decreases. This partly accounts for the increased risk of perforation with hydrophilic coated wires.
Courtesy: Abbott Vascular
FLEXIBILITY OF TIP
DETERMINANTS OF TIP FLEXIBILITY
JOINT
There is one or more joints in the wires with tip material some different to core material.
The number of joints and the nature of them influence the clinical performance of the wires. The joints could serve as hinge points and bend during guide wire passage.
