Guidewires are interventional procedures wires used to guide access, maneuver, or work through structures (e.g. vessels, urinary or biliary system).
They come in different shapes, lengths, diameters, stiffness, and hydrophilicity, and are classified according to their main use into:
On this page:
Diameter
The diameter usually ranges from 0.010–0.038 inches, but the most common ones are 0.014, 0.018, and 0.035-inch1.
Shape
Guidewires generally come with a torque device and may have a curved or straight tip, depending on the vessel or structure to navigate.
Hydrophilic properties
Both hydrophilic and hydrophobic wires are used for vascular access.
Hydrophilic wires
Characteristics
less thrombogenic compared to hydrophobic wires3
coated with plastic sheath and hydrophilic material for maximum lubricity
should be kept wet in a saline bowel to activate the hydrophilic properties
hard to manipulate - sticky when dry and slippery when wet
useful when low resistance is needed 2 - smooth gliding through small vessels
needs a torque device for easy manipulation and pinning
Hydrophobic wires
Characteristics
coated with Teflon or polytetrafluoroethylene (PTFE) 4 - increase lubricity and decreases the friction
does not prevent thrombus formation around the wire, which can be stripped and migrate during manipulation
easy to manipulate and grip - do not get sticky
offer resistance through narrow areas
may contain heparin coating to reduce thrombogenicity
some hydrophobic wires (e.g. Bentson wire), can be soaked in heparinized saline to ease exchanges with tools and catheters, and to prevent thrombus formation around the wire2
Indication
Hydrophobic wires make good access wires because they are easy to grip and to stabilize during the initial exchanges.