A new technique for cerebral angiography: the variable stiffness guidewire

Cerebral angiography can be performed with either a small-diameter, thin-walled catheter, or with a larger catheter using the "headhunter" technique. However, neither of these methods is satisfactory for catheterizing tortuous or angular arteries. The author has developed a variable stiffness guidewire (VSGW), which uses a small catheter and enables the neuroradiologist to catheterize tortuous arteries. The VSGW can be changed from flexible to stiff and back again while in the artery. New angiographic techniques based on four simple catheter curves are described. Using these techniques, the author has achieved an overall success rate of 98%.