Folded-Loop Guidewire Remodeling Technique: Catheterizing Markedly Angulated Branches during Intravascular Embolization Folded-Loop Guidewire Remodeling Technique: 색전술 시 급격한 분지 각도를 가지는 혈관의 선택적 진입 방법

ABSTRACT:

Purpose

Practical challenges are encountered in percutaneous intravascular procedures when applied to markedly angulated branching vessels. Herein, we introduced a folded-loop guidewire remodeling technique–the guidewire-shaping technique–to overcome difficult catheterization.

Materials and Methods

First, the tip of a 0.014-inch micro-guidewire was manually shaped like a pigtail loop. Second, the shaped guidewire was introduced into the microcatheter and was preloaded into the hollow metal introducer for suitability with the microcatheter hub. Gentle rotation of the guidewire after release from the microcatheter can create the preshaped pigtail loop configuration. On pulling back, the loop loosened, the configuration was changed to a small U-shaped tip, and the guidewire tip was easily introduced into the target artery.

Results

Between December 2019 and January 2022, the described technique was used in 64 patients (male/female, 49/15; mean age, 66.8 ± 9.5 years) for selective arterial embolization, after failed attempts with the conventional selection technique. The technique was successful in 63/64 patients (98%). The indications of embolization include transcatheter arterial chemoembolization, gastrointestinal bleeding, hemoptysis, trauma-induced bleeding, and tumor bleeding.

Conclusion

The folded-loop guidewire remodeling technique facilitates the catheterization of markedly angulated branching arteries; when usual catheterization method fails. Graphical Abstract

SUBMITTER:  

PROVIDER: S-EPMC10083636 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature