Guidewire: Difference between revisions

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==Crossing profile==
==Crossing profile==
===Simple lesions===


===Complex lesions and lesions in very tortuous vessels===
===Complex lesions and lesions in very tortuous vessels===

Revision as of 22:52, 23 October 2011

WikiDoc Resources for Guidewire

Articles

Most recent articles on Guidewire

Most cited articles on Guidewire

Review articles on Guidewire

Articles on Guidewire in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Guidewire

Images of Guidewire

Photos of Guidewire

Podcasts & MP3s on Guidewire

Videos on Guidewire

Evidence Based Medicine

Cochrane Collaboration on Guidewire

Bandolier on Guidewire

TRIP on Guidewire

Clinical Trials

Ongoing Trials on Guidewire at Clinical Trials.gov

Trial results on Guidewire

Clinical Trials on Guidewire at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Guidewire

NICE Guidance on Guidewire

NHS PRODIGY Guidance

FDA on Guidewire

CDC on Guidewire

Books

Books on Guidewire

News

Guidewire in the news

Be alerted to news on Guidewire

News trends on Guidewire

Commentary

Blogs on Guidewire

Definitions

Definitions of Guidewire

Patient Resources / Community

Patient resources on Guidewire

Discussion groups on Guidewire

Patient Handouts on Guidewire

Directions to Hospitals Treating Guidewire

Risk calculators and risk factors for Guidewire

Healthcare Provider Resources

Symptoms of Guidewire

Causes & Risk Factors for Guidewire

Diagnostic studies for Guidewire

Treatment of Guidewire

Continuing Medical Education (CME)

CME Programs on Guidewire

International

Guidewire en Espanol

Guidewire en Francais

Business

Guidewire in the Marketplace

Patents on Guidewire

Experimental / Informatics

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

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

Support (steerability and trackability)

Soft guide wires

Asahi soft guidewire | Hi-torque balance

Moderate support

Wisper wire | Wisdom | High torque balance middle weight

Extra support

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

Super extra support

Iron Man | Asahi Grand Slam

Crossing profile

Complex lesions and lesions in very tortuous vessels

Prowater | Choice PT | PT graphix intermediate

Guidewires Used to Cross Chronic Total Occlusions

Cross it Series | Miracle bros series | Shinobi | Confianza

Device Delivery Guidewires

Stabilizer | Wiggle wire

Peripheral Arterial Guidewires

Spartacore | V 18



TIPS IN CROSSING A LESION

1. Use a bend at the tip of the wire which is roughly the length of the diameter of the vessel proximal to the lesion. 2. If a wire repeatedly fails to cross a lesion, a. Adjust the guide, b. Use a balloon, transit, ultrafuse or twin pass catheter to direct the wire c. modify the bend at the tip. d. change the wire ( check the tip of the wire for evidence of wear and tear) 3. A wire in a balloon or a catheter ( ultrafuse, transit or exchelon) may help guide the wire through the lesion

SAFETY TIPS

1. Get used to a few wires to suit most situations 2. Always use the least traumatic wire for the lesion, >90% lesions could be crossed with standard “work horse” wires 3. Until familiar and comfortable, do not rush in to wires which are mote likely to perforate. 4. Avoid bending or buckling the wire 5. Never push a wire, let it find its “track” with 6. A ventricular premature beat could be a suggestion that the wire is off track, withdraw the wire immediately and redirect it. 7. Check every fluro and cine loop for evidence for perforation, embolization and dissection. If the picture quality is poor, then do not hesitate to increase the frame count/radiation to improve it. 8. If there is a suspicion of a perforation, then an emergent Echo should be performed on the table. ( link complications – perforation)


References


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