Comparison of hydrophilic guidewires used in endovascular procedures

The development of hydrophilic guidewires has provided the vascular interventionalist with an important tool to more effectively deliver diagnostic and therapeutic equipment.

To determine whether significant variation in performance exists between commonly used guidewires, a single-blinded, randomized study was conducted to evaluate three hydrophilic guidewires: the ZipWire (Boston Scientific Corp., Natick, Massachusetts), the HiWire (Cook, Inc., Bloomington, Indiana), and the Glidewire (Terumo Medical Corp., Somerset, New Jersey), which were used by three operators in 100 consecutive vascular disease patients. Dimensions evaluated included trackability, crossing, torque control, feel, support, time through anatomy, radiopacity, lubricity, lubricity retention and tip shape retention. Technical success, procedural success and occurrence of complications were also analyzed.

Results demonstrated that for these 10 guidewire characteristics, there was a statistically significant difference among operator ratings of the different hydrophilic wires, with the Glidewire rating statistically significantly higher on all characteristics compared to the other two guidewires. The Glidewire and ZipWire were more likely to have technical and procedural success compared to the HiWire (p < 0.05), but there were no differences between the guidewires in occurrence of patient complications.

These results demonstrate that there are measurable differences between hydrophilic guidewires based on guidewire characteristics and operator preference. This study provides an evaluation paradigm that may be useful for future evaluation of guidewire performance.