The Silverway Guidewire: An Observational Study on Successful Crossing when a Conventional J-tip Wire has failed

Dens, Jo; Buijs, Deborah M.F. van den; EM, Poels; Ferdinande, Bert; Cottens, D; Vrolix, M; Holvoet, Wouter; Ameloot, Koen

doi:10.31579/2641-0419/239

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…These anomalies are prone to bleeding and vascular complications and increased procedure time [ 7 , 8 ]. Other hydrophilic wires, such as Radifocus (Terumo, Tokyo, Japan) and Silverway (Asahi Intecc Co., Tokyo, Japan), are used to overcome these anatomical challenges [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Radifocus versus Silverway Guidewires for Percutaneous Radial Angiography Following Failed Use of a J-Tip Guidewire

et al. 2023

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Background:During transradial coronary angiography, when conventional J-tip wires fail to deliver catheters to the aortic root due to anatomical obstacles, additional hydrophilic wires, such as Radifocus (Terumo) or Silverway (Asahi), are used. We recently showed that the Silverway guidewire was effective at delivering the catheter to the aortic root. In this study, we aimed to compare the efficacy and safety of Radifocus and Silverway guidewires in 100 patients after failed use of the J-tip guidewire. Material/Methods:After patients had a failure of a conventional J-tip wire to reach the aortic root, 100 patients were 1:1 randomized to either the Silverway or Radifocus wire. All patients with failure of the J-tip wire were eligible. The primary endpoint was the time between wire entry in the catheter and successful delivery of the catheter to the aortic root. Secondary endpoints included change of access site, number of complications, and questionnaires on subjective wire assessments by the performing interventional cardiologist. Results:The primary endpoint was significantly shorter in patients randomized to the Silverway arm (median 30 s [21-39] vs 48 s [36-66]; P<0.001)). The percentage of patients with change of access site was not different between the groups (2 vs 2, not significant). Only 1 minor complication (2%) occurred, in the Radifocus group. Questionnaires revealed that torque control, crossing, and support were all significantly better with the Silverway wire (P<0.001). Conclusions:Silverway showed superior torque control, resulting in faster catheter delivery to the aortic root when compared with the Radifocus guidewire.

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Section: Introductionmentioning

confidence: 99%

“…The combination of these technologies incorporates good deliverability, torque transmission, and safety [ 5 ]. We recently showed that the Silverway guidewire is successful at delivering the guidewire to the aortic valve when the J-tip guidewire fails due to anatomical obstacles [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Radifocus versus Silverway Guidewires for Percutaneous Radial Angiography Following Failed Use of a J-Tip Guidewire

et al. 2023

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Enhancing Guidewire Efficacy for Transradial Access: The EAGER Randomized Controlled Trial

Bland,

Meere,

Mikhail

et al. 2024

Circ: Cardiovascular Interventions

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BACKGROUND: The 1.5 mm Baby J hydrophilic narrow J-tipped wire is a development of the standard 0.035” 3-mm J-tipped peripheral guidewire, designed to improve efficiency of transradial coronary procedures by safely navigating small caliber radial arteries to the aorta. There is currently a lack of evidence comparing the procedural success and safety of different peripheral guidewires used in transradial cardiac procedures. We compared the efficacy and safety of a narrow J-tipped hydrophilic 0.035” wire (intervention, Radifocus Baby J guidewire; TERUMO Co, Tokyo, Japan) versus a standard fixed-core 0.035” J wire (control). METHODS: Investigator-initiated, blinded, Australian, multicenter randomized trial in patients undergoing clinically indicated coronary angiography or percutaneous coronary intervention. Patients were randomized 1:1 to use either the control guidewire or the intervention guidewire. The primary end point (technical success) was defined as gaining aortic root access with the randomized guidewire. RESULTS: In all, 330 patients were randomized between October 2022 and June 2023 (median age was 69 years, 36% were female, and body mass index was 29 kg/m 2 ). The primary end point was achieved more frequently in the intervention group (96% versus 84%; absolute risk reduction 12% [95% CI, 5.7–18.3]; P <0.001). Women assigned to the control wire experienced a higher failure rate compared with men (31% versus 8% in men; P <0.001). Fluoroscopy time was significantly lower in the Baby J group (median, 344 versus 491 seconds; P =0.024). The main mechanisms of failure using the control wire were radial artery spasm (15/26; 57%) and subclavian tortuosity (5/26; 19.2%). There were no differences in overall procedure times, major adverse cardiovascular events, or vascular complications between guidewires. CONCLUSIONS: A narrow 1.5 mm J-tipped hydrophilic guidewire resulted in greater technical success and reduced fluoroscopy time compared with the standard 3-mm J-tipped nonhydrophilic guidewire. The guidewire is safe and demonstrated key incremental benefits for the transradial approach, particularly in women. REGISTRATION: URL: https://www.anzctr.org.au/ ; Unique identifier: ACTRN12622001557729.

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The Silverway Guidewire: An Observational Study on Successful Crossing when a Conventional J-tip Wire has failed

Cited by 2 publications

References 7 publications

Comparison of Radifocus versus Silverway Guidewires for Percutaneous Radial Angiography Following Failed Use of a J-Tip Guidewire

Comparison of Radifocus versus Silverway Guidewires for Percutaneous Radial Angiography Following Failed Use of a J-Tip Guidewire

Enhancing Guidewire Efficacy for Transradial Access: The EAGER Randomized Controlled Trial

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