Guidewires in clinical practice: applications and troubleshooting

Abstract

Guidewires are commonly used in clinical practice over a wide range of specialties. Their use has become more popular as a result of advances in endourology and interventional radiology, as well as in angiographic procedures. While there are many papers regarding individual guidewires and certain technical aspects, for the interested clinician there is little to give a generalized overview within the literature. This paper aims to review guidewires in terms of their make-up, applications and potential complications. Technical points are described, as well as rescue methods for complications, in the hope of preventing future litigation for those reading the paper.

Naso-pharyngeal entrapment. An unusual complication of naso-jejunal feeding tube insertion using a guidewire

“…Other reports have included perforation of pharyngeal or oesophageal pouches, as well as of the trachea. One of the authors (MK) has already highlighted the problems of guidewires in clinical practice, particularly suggesting that familiarity with equipment is crucial (3). This case only reinforces that message.…”

Troubleshooting for Ureteroscopy Complicated by Unexpected Guidewire Looping and Entrapment

“…1 Although they help urologists perform advanced endourology procedures, they may become the source of potential complications such are perforation, bleeding, and kinking. 2,3 Looping of guidewire is another poorly described and bizarre complication in the literature and is usually combined with knotting or kinking. 2,3 However, looping and entrapment of a hydrophilic guidewire inside the ureter has never been reported in the literature.…”

“…2,3 Looping of guidewire is another poorly described and bizarre complication in the literature and is usually combined with knotting or kinking. 2,3 However, looping and entrapment of a hydrophilic guidewire inside the ureter has never been reported in the literature. We report such a case and describe troubleshooting for this scenario.…”

Guidewires for lower extremity artery angioplasty: a review

“…Lower limb arterial endovascular revascularisation is increasingly performed worldwide due to the rising prevalence of peripheral artery disease as well as the improvement in equipment and techniques. Guidewires (GWs) are necessary tools for any type of vascular angioplasty, allowing lesion crossing and advancement of devices such as balloons and stents beyond a lesion 1 . Until recently, the choice of GWs specifically designed for lower extremity artery angioplasty has been limited.…”