title: Initial experience with a multiple parallel guidewire support system for complex tortuous aortic arch navigation and great vessel catheterization: technical note.
abstract: The ability to traverse an anatomically challenging and complex arch is paramount to the success of any neuroendovascular procedure. With age, the aortic arch becomes elongated, calcified, and less compliant. The authors present the initial experience with a multiple parallel guidewire system (ZigiWire Mode 3) for catheterization through a complex tortuous aortic arch to access extracranial vessels. The ZigiWire is an organized guidewire system that uses consecutive delivery of 3 small-diameter (0.014-inch) guidewires that are progressively advanced in parallel to secure support-wire access. The authors have found it useful in situations in which traditional methods for great-vessel access have failed. Moreover, the progressive construction of a large wire from smaller wires prevents "kickback" force from a single larger guidewire, allowing stable distal access. The authors have been able to advance different diagnostic and guide catheters over the ZigiWire. This guidewire has allowed them to successfully complete neuroendovascular procedures in patients who were previously considered unsuitable for the procedure because of tortuous vascular access.
authors.affiliation: Departments of 1 Neurosurgery and.|Department of Neurosurgery, Gates Vascular Institute, Kaleida Health.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Rangel-Castilla
authors.affiliation: Departments of 1 Neurosurgery and.|Department of Neurosurgery, Gates Vascular Institute, Kaleida Health.
authors.forename: Hakeem J
authors.initials: HJ
authors.lastname: Shakir
authors.affiliation: Departments of 1 Neurosurgery and.|Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York.|Department of Neurosurgery, Gates Vascular Institute, Kaleida Health.|Toshiba Stroke and Vascular Research Center, University at Buffalo, State University of New York; and.|Jacobs Institute, Buffalo, New York.
authors.forename: Adnan H
authors.initials: AH
authors.lastname: Siddiqui
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D057510:Endovascular Procedures / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: catheterization; great vessels; guidewire support; tortuous carotid artery