Zip Wire Urology

[Nguyet Edmondson]

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Materials and methods: Certain 0.035-inch diameter guide wires were tested with regard to tip bending force, shaft bending force, pull force and tip puncture force, namely the Roadrunner PC and polytetrafluoroethylene (PTFE) wire guide (Cook Urological, Spencer, Indiana), Glidewire, Bentson type 15 cm flexible tip PTFE coated guide wire and Amplatz super stiff Urowire XF (Boston Scientific Microvasive, Miami, Florida), Bentson guide wire and Amplatz guide wire (Applied Medical, Rancho Santa Margarita, California) and the PTFE coated Bard guide wire (Bard Urological Division, Covington, Georgia).

Results: Regarding guide wires used for access, the Boston Scientific PTFE guide wire with a 15 cm flexible tip required the least amount of force to deflect the tip. Of the 3 cm flexible tip guide wires the Applied Bentson guide wire had the most flexible tip and the Bard guide wire had the stiffest flexible tip. The Boston Scientific Glidewire required the least amount of force to pull from a tortuous pathway and this guide wire also required the greatest force (4 times as much force as the other guide wires) to puncture the aluminum foil (p Conclusions: Brand name guide wires designed for the same purpose appear to differ markedly with regard to flexibility, lubricity and shaft stiffness. In general, floppy tip and nitinol based guide wires appear to be best used for access with an emphasis on tip flexibility and a low friction coating, while the stiffer shaft guide wires are selected for coaxial passage of catheters, stents and sheaths.

Boston Scientific's Amplatz Guidewire is a stainless steel wire with a flat-wire coil and PTFE coating. It is available in a variety of diameters and tip configurations to fit your preferences, your patients, and your procedures, designed so you can confidently straighten tortuous anatomies1 and deliver heavier instruments.2

FORT Floppy Guidewire and Marker Wire is designed to provide enhanced steering for frontline cases with a soft tip, silicone coating and unibody stainless steel core. FORT Floppy Marker integrates a precise lesion measurement system without compromising performance.

FORT Moderate Support Guidewire offers the torque response and support needed to deliver most interventional devices. FORT Moderate Support Marker Wire integrates a precise lesion measurement system without compromising performance.

Building on Trusted Technology.

Savion Guidewires exhibit attributes ideally matched for BTK interventions to help you treat complex lesions successfully and restore blood flow to the leg.

Whether you prefer the stiffness and control of stainless steel or the flexibility and resiliency of nitinol, Cook Medical has a comprehensive assortment of wire guides to fit your preferences and meet your procedural needs.

HiWireNitinol Core Wire Guide

Used to gain ureteral access, to establish a tract, and to assist in the placement, replacement, and exchange of medical devices during urological procedures. Choose between standard- and stiff-body options.

RoadrunnerPC Hydrophilic Wire Guide

Used to gain ureteral access, to establish a tract, and to assist in the placement, replacement, and exchange of medical devices during urological procedures. May also be used for catheter positioning and exchange in a tortuous or kinked ureter, traversing a stone en route to the kidney, or in cases demanding enhanced control and high radiopacity. Choose between standard- and stiff-body options. Double flexible tip configurations are also available.

Fixed Core Wire Guide

Used to gain ureteral access, to establish a tract, and to assist in the placement, replacement, and exchange of medical devices during urological procedures. Choose between standard and Bentson options.

The use of guide wires has become a core skill utilised by urologists, especially within the field of endourology. The authors take us through the development of the guide wire and their current use in urology.

When one mentions the use of a guide wire to safely gain access and introduce instruments into a lumen or hollow organ, many will know about the Seldinger technique. Named after the esteemed Dr Sven-Ivar Seldinger, who, before developing his technique, used a piano wire when trying to advance a polyethylene tube for angiography [2]. However, Seldinger himself did not invent the concept of a guide wire, but rather developed a technique on how to effectively use them. He then went on to manufacture the first modern day guide wire with the Stille-Werner Company.

Today, guide wires are developed for specific specialities and specific situations. Each one is designed and manufactured with different characteristics in mind. In fact, the basic concepts of guide wire technology actually cover 15 broad areas: trackability, torqueability, flexibility, crossability (ability to navigate past obstructions), supportability (ability to support another device over it), core diameter, core taper, tip style, shaping ribbons, tip coils, coatings, support, tip load, support catheters, and wire length [12].

It is also not only the characteristics of the wires that vary, but also the materials from which they are made from. Nitinol (nickel-titanium alloy) or steel is usually the main core in most wires. Some guide wires are coated with other substances such as silicone or polytetrafluoroethylene (PTFE) which enhance lubricity, or with other novel hydrophilic coatings to allow for easier manoeuvrability in tortuous lumens [13].

The field of guide wire technology and the birth of endourology have encouraged research into guide wire characteristics, and there are now publications on the analysis of guide wire characteristics and their clinical use in everyday practice. They have facilitated an explosion of progress within the field of endourology and are used in a diverse number of urological procedures and clinical situations including ureteroscopy, stent insertions, percutaneous nephrolithotomy (PCNL) access, facilitating dilation of urethral and uretero-ileal anastomotic strictures, and even the placement of difficult urethral catheters.

We should also not forget the important use of the guide wire by some of our colleagues, the interventional radiologists who are able to use a multitude of different guide wires for the placement of nephrostomies and antegrade stents when an endoscopically retrograde approach is just not feasible, or even for renal embolisation, thereby giving our patients an additional option of treatment, especially in those in whom a general anaesthetic may not be suitable.

A wide range of wires are used in interventional radiology with varying tips and flexibilities. These include the ultra-stiff wire that is used in nephrostomy insertion after initial puncture of the kidney. This allows for the loading of a robust dilator that is used to dilate the nephrostomy tract prior to nephrostomy tube insertion. In the same way, the super stiff wire is also used in PCNL operations and suprapubic catheter insertions in order to load the dilator as well as the working sheath.

Hydrophilic wires are also commonly used by interventional radiologists for the insertion of antegrade ureteric stents via nephrostomies. For example, a patient who has an obstructed kidney after a transurethral resection of a bladder tumour would likely have a nephrostomy inserted in the first instance. After which, an antegrade stent might be considered, however, given the possibility of a narrowed ureteric orifice and recent bladder resection resulting in friable and possibly thin bladder wall, the extremely flexible hydrophilic wires are a good option to both navigate the ureteric orifice as well as be less likely to traumatise the surrounding bladder wall.

Guide wires have come a long way since the first silver thread and piano wire. The need for advancements in this area has produced an arsenal of tools from which urologists (and other specialities) can choose from, each designed and manufactured for different clinical purposes.

The TERUMO GLIDEWIRE Guidewire product line that you know and trust offers a robust range of tip shapes and wire configurations, making it possible for you to find the right tools for your challenging procedures.

GLIDEWIRE Urologic Guidewire is the most preferred hydrophilic coated wire, and has years of proven performance. It's kink-resistant core, coated with a proprietary polymer jacket and a lubricious hydrophilic coating, facilitates efficient access and reliable device tracking.

Olympus Continuum, is a comprehensive platform of education and training experiences led by healthcare experts from around the world. Learning opportunities include hands-on courses, online learning, lectures and workshops, peer-to-peer training, accredited continuing education, and on-demand learning.

Constructed of stainless steel, the straight, flexible tip design is used primarily in urology to establish a tract and assist in the placement of medical devices. This wire guide is not intended for PTCA use.

The products on this website are available for sale in the United States. Reference Part Numbers are not the same in all countries/regions. For products available in other countries, please choose one of our other websites from the region selector at the top of the site or contact your local Cook Medical representative.

MEDpro Guide Wires are used to gain ureteral access to establish a tract and to assist in the placement, replacement and exchange of medical devices during urological procedures. Please note: This type of guide wire is not intended for percutaneous transluminal coronary angioplasty (PTCA) use.

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