Guidewires Used in Thoracic Aortic Endografting

Abstract

A wire consists of two main components: (1) a central shaft of stainless steel or nitinol and (2) a distal flexible tip shaped as a spring coil made with platinum or tungsten. Wires with a nitinol core are kink resistant while those with stainless steel are more susceptible to kinking. The tip can be soft, stiff, intermediate or floppy J tipped or angled tip. Soft tip consists of inner core end to end combined with tip shaping capabilities is more aggressive in crossing tight lesions. Floppy tip has no inner core to the tip of the wire and usually comprised of a ribbon of stainless steel, nitinol, gold, or platinum which allows you to shape the wire and allows for safe traumatic selection of vessels. “J” tip allows for safe passage of wire through: irregular lesions stents (keeping wire in “true” lumen and not through struts). Angled tip is selectively used to steer wire because of tip angle. Wires can have a shaped or pre-shaped tip (Fig. 5.1).