Instrumentation: Guidewires for Peripheral Interventions

  • Lorenzoni RobertoEmail author
  • Lorenzoni Giulia
  • Ferraresi Roberto


The guidewire (GW) is probably the most important tool for endovascular treatment of atherosclerotic disease. Indeed, crossing and treatment of a lesion are only possible when the GW has been passed beyond the target lesion. Initially the GW serves to cross the lesion, and then to deliver devices (balloons, stents) across the lesion. Peripheral lower extremity percutaneous arterial revascularization can be achieved using a variety of GWs that may differ in calibre and have a large variety of biomechanical tip and body properties. As the choice of an appropriate GW is critical for the success of arterial angioplasty, knowledge about the properties and performance of different GWs should be well understood by operators, allowing them to tailor the choice of the device to the lesion characteristics and location, as well as to the intended revascularization strategy. Based on general characteristics, we can identify the workhorse, crossing, and position for GWs. In this chapter we describe some of the key characteristics of GWs and their use in different segments of lower extremity arterial revascularizations.


  1. 1.
    Kipling M, Mohammed A, Medding RN. Guidewires in clinical practice: applications and troubleshooting. Expert Rev Med Devices. 2009;6(2):187–95.CrossRefPubMedGoogle Scholar
  2. 2.
    Lorenzoni R, Ferraresi R, Manzi M, Roffi M. Guidewires for lower extremity artery angioplasty: a review. EuroIntervention. 2015;11(7):799–807.CrossRefPubMedGoogle Scholar
  3. 3.
    Ferraresi R, Palena LM, Mauri G, Manzi M. Tips and tricks for a correct-in.endo approach. J Cardiovasc Surg. 2013;54(6):685–711.Google Scholar
  4. 4.
    Bolia A, Miles KA, Brennan J, Bell PR. Percutaneous transluminal angioplasty of occlusions of the femoral and popliteal arteries by subintimal dissection. Cardiovasc Intervent Radiol. 1990;13(6):357–63.CrossRefPubMedGoogle Scholar
  5. 5.
    Lorenzoni R, Lisi C, Lazzari M, Bovenzi F. Tools & techniques: above the knee angioplasty by transradial access. EuroIntervention. 2012;7(9):1118–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Schmidt A, Bausback Y, Piorkowski M, Werner M, Braunlich S, Ulrich M, Varcoe R, Friedenberger J, Schuster J, Botsios S, Scheinert D. Retrograde recanalization technique for use after failed antegrade angioplasty in chronic femoral artery occlusions. J Endovasc Ther. 2012;19(1):23–9.CrossRefPubMedGoogle Scholar
  7. 7.
    Manzi M, Fusaro M, Ceccacci T, Erente G, Dalla Paola L, Brocco E. Clinical results of below-the knee intervention using pedal-plantar loop technique for the revascularization of foot arteries. J Cardiovasc Surg. 2009;50(3):331–7.Google Scholar
  8. 8.
    Graziani L, Silvestro A, Monge L, Boffano GM, Kokaly F, Casadidio I, Giannini F. Transluminal angioplasty of peroneal artery branches in diabetics: initial technical experience. Cardiovasc Intervent Radiol. 2008;31(1):49–55.CrossRefPubMedGoogle Scholar
  9. 9.
    Fusaro M, Tashani A, Mollichelli N, Medda M, Inglese L, Biondi-Zoccai GG. Retrograde pedal artery access for below-the-knee percutaneous revascularisation. J Cardiovasc Med (Hagerstown). 2007;8(3):216–8.CrossRefGoogle Scholar
  10. 10.
    Palena LM, Manzi M. Extreme below-the-knee interventions: retrograde transmetatarsal or transplantar arch access for foot salvage in challenging cases of critical limb ischemia. J Endovasc Ther. 2012;19(6):805–11.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Lorenzoni Roberto
    • 1
    Email author
  • Lorenzoni Giulia
    • 2
  • Ferraresi Roberto
    • 3
  1. 1.Department of Diagnostic and Interventional CardiologySan Luca HospitalLuccaItaly
  2. 2.Department of Diagnostic and Interventional RadiologyUniversity of PisaPisaItaly
  3. 3.Peripheral Interventional and Diabetic Foot UnitHumanitas GavazzeniBergamoItaly

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