Development of a safe guidewire

Abstract

As the result of a locking phenomenon that may occur in a guidewire inside a metal puncture needle when using the Seldinger technique to insert a central venous catheter, the guidewire can break and cause an embolism. To counter this possibility we devised a guidewire with a structure that made it difficult for locking to occur and compared it to conventional guidewires. Conventional guidewires are wound lengthways with a spring. The improved version has a special multi-ply structure. A series of 100 cases were divided into two groups: group A, the conventional guidewire group; and group B, the improved guidewire group. We punctured the internal jugular vein and attempted insertion of the guidewire through the side hole of a 22-gauge metal needle. We then compared the frequency of locking and the frequency of bending of the guidewire tips that have been withdrawn. In group A, locking occurred in 72% of the cases where the guidewire was unable to be inserted, but this figure was 0% in group B. The improved guidewire has the advantage of reducing the risk of locking and of guidewire breakage.

Fractured Metal Wire in the Right Ventricle, a Cause of Cardiac Tamponade

“…In our case, we think the guide wire fragment may have resulted from a phenomenon called "locking" [5,6]. This problem is thought to occur, during the surgical insertion, when the guide wire becomes bent and catches on the beveled part of the introducer needle [5,6]. The guide wire can not be advanced nor withdrawn.…”

“…A guide wire often consists of a stainless steel core wound lengthways by a spring made of the same material (Figure 3). There has been a proposed guide wire design [5] which consists of thin wires of same material plied in a straight line to form a single guide wire (multiply). In our case, we think the guide wire fragment may have resulted from a phenomenon called "locking" [5,6].…”

“…There has been a proposed guide wire design [5] which consists of thin wires of same material plied in a straight line to form a single guide wire (multiply). In our case, we think the guide wire fragment may have resulted from a phenomenon called "locking" [5,6]. This problem is thought to occur, during the surgical insertion, when the guide wire becomes bent and catches on the beveled part of the introducer needle [5,6].…”

Guidewires in clinical practice: applications and troubleshooting

“…This may take the form of a 'spring', where only the two ends of the outer coil are welded to the inner core, or a 'multiply', where more welds can be involved and many filaments are wound in the same direction and welded throughout their length [5]. Some (older) wires employed a 'safetywire' running up the outside of the coil; this was designed to prevent breakage by overflexing of the wire.…”

Influence of Epidural Needle Treatment at the Heel of the Bevel on Catheter Breakage

“…In such a situation, the catheter is hypothetically considered to be broken by being pinched between hard tissue and the heel of the epidural needle bevel [7]. It has been reported that this cause of catheter rupture and guide-wire issues during central venous catheter insertion have a similar mechanism [8]. Therefore, to reduce the risk of epidural catheter damage by epidural needles, needles with special changes to the heel of the bevel are commercially available.…”