Comparison of guidewires for successful cannulation of biliary stenosis and targeting of biliary branches in ERCP

Abstract

Background and Study Aims: Guidewires play a crucial role in endoscopic retrograde cholangiopancreatography. The ability to pass through stenosis, and the ability to seek the desired biliary branch are particularly important. In this study, we aimed to compare these specific abilities in various guidewires by using a bile duct model. Patients and Methods: Seven 0.025-inch angle-type guidewires (VisiGlide2, Fielder 25, EndoSelector, NaviPro, Jagwire Plus, RevoWave DualMaster, and J-WIRE prologue ST) were evaluated. To compare these, a bile duct silicone model was prepared. The time from the entry of the guidewire into the common bile duct with the stenosis to the emergence of the guidewire from the common bile duct after reaching two target intrahepatic bile duct branches was measured. Results: VisiGlide 2 and Fielder 25 were the fastest guidewires, whereas Jagwire Plus was the slowest. Conclusions: In this study, a guidewire with a tip deflection height of approximately 9 mm and a hydrophilic coating length of 7 to 8 cm achieved the fastest completion time for the course. In clinical practice, it is important to consider the performance required in various scenarios and select the most appropriate guidewire. The results of this model test, which focused on the time required to complete the course around the model, can serve as a foundation for guidewire selection. This method holds potential utility in future guidewire development.

Structural factors influencing the clinical performance of 0.025-inch guidewires for pancreatobiliary endoscopy: An experimental study

“…During a seeking ability test involving 20 endoscopists, Fielder 25, VisiGlide2, and J-WIRE Prologue ST had high TIS rates. Kobayashi et al conducted a technical test involving two endoscopists to verify the seeking ability of seven guidewires using a bile duct model [11]. Although the methods and bile duct model used were different from our test, the results of the good seeking ability of Fielder 25 and VisiGlide2 were consistent.…”

“…In contrast, experimental studies may be helpful for objective assessment of clinical performance of guidewires. Recently, five studies involving experiments to evaluate guidewire performance have been reported [5,6,9,10,11]. In these studies, several guidewire products were examined and compared regarding clinical performance, ▶…”

“…The 0.025-inch guidewires used for ERCP and EUS-BD are required to have the following clinical performance: good seeking ability, lubricity, flexible tips, and stiff shafts. Several studies have evaluated these characteristics of specific guidewire products [5,6,9,10,11]. However, those studies primarily focused on comparisons among guidewire products and lacked a structural perspective that could be useful for guidewire development.…”