Experimental study of loop shape using 0.025-inch ERCP guidewires (with videos)

Area of Science:

• Medical Devices
• Gastroenterology
• Endoscopic Procedures

Background:

• Guidewire duct penetration during endoscopic retrograde cholangiography (ERC) can cause adverse events like acute pancreatitis.
• Forming a loop with the guidewire may prevent duct penetration.
• Evaluating guidewire characteristics is crucial for procedural safety.

Purpose of the Study:

• To experimentally assess which guidewire types most easily form a loop shape.
• To compare the flexibility, shaft stiffness, and loop-forming ability of different guidewires.

Main Methods:

• An ex vivo model was used to evaluate six 0.025-inch angle-type guidewires.
• Key parameters assessed included tip flexibility, shaft stiffness, and ease of loop formation.
• Deformation behavior and time to achieve a loop shape were recorded and analyzed.

Main Results:

• Significant differences in flexibility and stiffness were observed among the guidewires.
• MICHISUJI guidewire required the lowest maximum load (6.8 g) to deform before loop formation.
• MICHISUJI demonstrated the fastest mean time to achieve a loop shape (6.2 seconds).

Conclusions:

• Guidewire flexibility and stiffness significantly impact loop formation.
• MICHISUJI guidewire exhibits superior characteristics for easy loop formation compared to others tested.
• Further clinical studies are needed to confirm the efficacy of guidewire loop formation in preventing duct penetration.