Innovation in interventional cardiology

Hydrophilic-coated Silverway guidewire

Dr. José R. Rumoroso

05/08/2020

When performing catheterisation via radial access, interventional cardiologists use a coated guidewire. If the arteries are excessively tortuous or severely calcified, it may be necessary to use a hydrophilic polymer-coated guide wire, which carries the risk of perforating secondary branches, as these guidewires slip easily, but provide limited tip control. In some cases, coronary angioplasty guidewires are needed to negotiate a highly-tortuous radial artery, but they lack the sufficient support to advance the catheter.

The Silverway guidewire (Asahi Intecc Co, LTD., Japan) represents a great innovation in endovascular guidewires: it facilitates access in these difficult situations and has substantially better performance and safety than other commonly-used guidewires. It is a 0.035’’ metal guidewire, with a double coil structure at the distal tip and a multi-wire coil with ACT ONE technology in the proximal shaft. This structure is the same as that of angioplasty guidewires. It has a hybrid coating along its entire length. The distal 15 cm have a silicone coating that provides tactile feedback from the tip to the hand. This silicone coating improves safety, as it prevents the guidewire from perforating the vessel. Proximal to these 15 cm, the guidewire has a hydrophilic coating that facilitates smooth delivery in the arteries. The proximal shaft is silicone-coated, to provide better control of the guidewire and 1 to 1 torque transmission to the tip.

Among the available lengths, of note is the 180 cm version, which allows exchange of catheters in the ascending aorta while maintaining the desired position of the guidewire and the 1.5 mm J shape, which is easily straightened manually. The tip of the guidewire is radio-opaque, allowing it to be visualised at all times. This guidewire can be used for any access that is difficult to navigate due to tortuosity or calcification.

In my opinion, this guidewire represents innovation in a field in which I thought nothing remained to be invented.

Palabras clave: guía endovascular. Keywords: endovascular guidewire.