Folded-Loop Guidewire Remodeling Technique: Catheterizing Markedly Angulated Branches during Intravascular...

Area of Science:

• Interventional Radiology
• Vascular Surgery
• Medical Device Innovation

Background:

• Percutaneous intravascular procedures face challenges in markedly angulated branching vessels.
• Conventional catheterization techniques can be difficult or fail in these anatomies.

Purpose of the Study:

• To introduce and evaluate a novel folded-loop guidewire remodeling technique.
• To overcome difficulties in catheterizing severely angulated branching arteries.

Main Methods:

• Manually shaping the tip of a 0.014-inch micro-guidewire into a pigtail loop.
• Introducing the shaped guidewire into a microcatheter and preloading it into a hollow metal introducer.
• Utilizing gentle rotation and controlled pullback to navigate the guidewire into the target artery.

Main Results:

• The technique was applied in 64 patients between December 2019 and January 2022.
• Successful catheterization was achieved in 63 out of 64 patients (98% success rate).
• Indications included transcatheter arterial chemoembolization, gastrointestinal bleeding, hemoptysis, trauma, and tumor bleeding.

Conclusions:

• The folded-loop guidewire remodeling technique effectively facilitates catheterization of markedly angulated branching arteries.
• This technique provides a viable solution when conventional methods fail.