A new guidewire technique for difficult cardiac catheterization.
OBJECTIVE
To propose a simple guidewire technique to resolve the problem of difficulty in advancing catheters or guidewires during vascular and cardiac catheterization.


METHODS
A 0.035-inch J-tip guidewire was reshaped manually at the distal 7- to 8-cm portion, including the flexible part and 2-3 cm of the stiff part, into zigzag shape. With this modification, the guidewire became much more trackable and could be advanced to the right position.


RESULTS
In the past 2 years, this 'zigzag wire technique' was applied in cardiac catheterization with high success rates for cases with difficulty in advancing either catheters or guidewires. This wire technique was applied in peripheral arterial tortuosity or stenosis (18 cases, with success in 17), aortic aneurysm (successful in all 7 cases), aortic stenosis (11 cases, successful in 8), and dilated right heart chambers (successful in all 6 cases). No complications resulted from the use of this guidewire technique.


CONCLUSIONS
This simple method of guidewire modification would be very helpful in difficult vascular and cardiac catheterization when difficulty in advancing catheters or wires was encountered.
Liau
Chiau-Suong
CS
Department of Internal Medicine, Section of Cardiology, College of Medicine, National Taiwan University, Taipei, Taiwan, ROC. csliau@ha.mc.ntu.edu.tw
Ho
Shinn-Ge
SG
Chen
Sung-Nan
SN
Yang
Li-Fen
LF
D000368:Aged; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D006328:Cardiac Catheterization / Q000379:methods*; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging / Q000601:surgery*; D002406:Catheterization, Peripheral / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography