Guidewire Performance vs Manufacturing Design
The following are among the most important design and process engineering considerations affecting guidewire performance. Each procedure that uses a guidewire creates slightly different demands. These issues need to be addressed during development and fabrication of a guidewire device via proper choice of materials and technical specifications.
Strength vs Flexibility
Guidewire designs need sufficient stiffness to resist kinking and prolapse. They also need to be flexible enough to gently navigate through the tortuous, fragile pathways of the vascular system to arrive safely at the procedural goal site.
The ability to pass through narrowed – stenosed – lesion areas is vital to the guidewire’s function. Inability to pass through to the target area derails any procedure. This challenge is addressed through a combination of a stiffer body with a more flexible tip.
The transition length from flexible tip to stiffer wire must be sufficiently subtle; a too abrupt transition can cause tracking difficulties.
Trackability refers to the ability of the wire to move through the vasculature to the length required; at some distance, the pressures on the wire may become too strong and the tip will kink or prolapse, making further movement impossible.
Guidewires are available in different stiffness and with different tip options to address various insertion and maneuverability challenges.
Steering and Maneuverability
Ease of maneuverability is vital to prevent injury to the patient, and for speedy accuracy at reaching the target area. The primary measure of how easy a guidewire design is to handle is its torque ratio. Optimally the torque ratio from proximal to distal ends should be one-to-one, meaning the operator’s motions are related precisely to the guidewire’s tip. Additionally, some coatings and treatments can enhance the operator’s tactile sense as the wire moves.
A radio-opaque marker visible on the fluoroscope monitor displays the location of the guidewire tip throughout the procedure, even though the rest of the wire may be too small to see. Though a seemingly small factor, the clear visibility of this marker is vital for safe progress.
The guidewires shape memory refers to its ability to retain its original shape after moving through a great variety of curves and angles. A wire that becomes distorted during its progress displays reduced torque responsiveness that may ultimately fail to reach the targeted area or may even become trapped along the route.
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