guidewires_cath_lab_123presentation.pptx

guidewires_cath_lab_presentation.pptx

1. Introduction Role of guidewires: Essential tools for diagnostic and interventional cardiology procedures Primary function: To cross lesions and guide device delivery Key requirements: Flexibility, torque control, trackability, atraumatic tip

2. Basic Anatomy of a Guidewire Core wire: Stainless steel or nitinol – determines stiffness and torque response Coating: Hydrophilic or hydrophobic – affects friction and trackability Tip: Shaped or shapeable – controls vessel navigation Support/shaft: Proximal section provides pushability and support

3. Classification of Cath Lab Guidewires Diagnostic Guidewires: For coronary angiography, flexible with soft tip Interventional Guidewires: For PTCA and other interventions, balance support with atraumatic navigation

4. Types of PTCA Guidewires By Tip Design: Straight Tip – for tight lesions; Angled Tip – for tortuous vessels By Coating: Hydrophilic – low friction; Hydrophobic – good tactile feedback By Core Material: Stainless Steel – excellent torque; Nitinol – superelastic By Support Level: Low, Moderate, or Extra/High Support depending on lesion

5. Key Properties of PTCA Wires Torqueability: Precise control and navigation Trackability: Ability to follow vessel path smoothly Pushability: Ability to transmit force to cross tight lesions Tip Load: Force needed to bend tip Radiopacity: Visibility under fluoroscopy Shape retention: Ability of the tip to maintain pre-set shape

6. Speciality Guidewires in Cath Lab Chronic Total Occlusion (CTO) wires: High tip load, tapered tip Microcatheter compatible wires: Designed for support and exchange Buddy wires: Two wires used simultaneously for extra support

7. Popular Commercial Examples Asahi Intecc: Sion, Gaia, Miracle (CTO) Boston Scientific: BMW (Balance Middle Weight), Choice PT Terumo: Runthrough, Crosswire Abbott: Hi-Torque Balance, Whisper

8. Wire Selection Strategy Lesion type: soft plaque vs calcified vs CTO Vessel anatomy: tortuous, small caliber, or side branches Device to be delivered: balloon vs large stent

9. Handling and Safety Tips Shape the tip carefully Avoid excessive force to prevent dissection or perforation Regularly check wire integrity

10. Conclusion The ideal wire depends on lesion complexity and operator preference Understanding wire properties improves success rates and reduces complications