Guidewire tip

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Characterizing the Physical Characteristics of a Coronary Guidewire Using the Tip Load

One way of quantifying some of the physical features of a coronary guidewire is by using a strain gauge to measure the force needed to bend a wire when exerted on a straight guidewire tip, at a point 1 cm from the tip. Using this method, the tip loads in ascending order are (from less stiff to more stiff) 3 gm, 4.5 gm, 6 gm, 9 gm and 12 gm (ultra stiff). As stiffness increases the wire becomes prone to perforating the vessel.

Determinants of Tip Flexibility

There can be one or more joints made of different materials in the tips of guidewires. The number of joints and the nature of the joints can influence the clinical performance of the wires. These joints can serve as hinge points and bend during guidewire passage.

Core To Tip Guidewires

When the core is extended to the tip, that increases pushability, precise steering, tip control, tactile feel and torquability. This can be a useful feature for example in probing chronic total occlusions. If there is a two piece tip to the guidewire, then shaping is easy and the wire is likely to retain its shape, a property called “wire memory”.

Shaping Ribbon

Incorporation of a shaping tip yields a softer tip that allows for shape retention.

Spring Coil Tip

1. Spring coil - Safer than hydrophilic coated or polymer tip wires - less risk of perforation

2. Distal weld

Tip Cover

The tip can be covered in either a polymer or plastic. This covering can provide either lubricity or smooth tracking through vessel tortuosity. Examples of tip covers are shown below:

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