What is medical guidewire?

  • Clinical application

Medical guidewire is small-diameter, flexible wire inserted into the body in order to guide larger instruments such as a catheter or feeding tube. The use of guide wires on humans
was first developed by German physician Dr. Werner Forssmann in 1929 for cardiac
catheterisation. Since then, guide wires have become smaller, more complex, and made with a
variety of materials in order to handle a range of medical operations.

According to functions, they can be divided into working guidewire and chronic total occlusion (CTO) guidewire. It is used to enter the coronary artery or cross the tortuous, calcified, narrow, and collateral circulation to reach the target, and establish a track to deliver balloons, stents, and micro catheters; it is used to upgrade or downgrade the technology to open coronary occlusive lesions; to enter the coronary artery branch in advance for protection and road marking functions.

  • Device composition

Although guide wires have different characteristics, their basic structure includes four parts: core, tip, cover, and coating. 

The core is the basic structure of the guidewire and can be functionally divided into three segments: the shaping segment, the transition segment (tapered) and the support segment. The material of the core determines the strength, durability, and flexibility of the guide wire, and is usually stainless steel, nickel-titanium alloy, or high-tensile stainless steel, which runs through the entire length of the guide wire in a cylindrical shape . Stainless steel is the earliest and most commonly used guide wire core manufacturing material. It has strong hardness, good support, pushability and torque conductivity, but it has poor flexibility and is easy to wind.

guidewire components

The core is the basic structure of the guidewire and can be functionally divided into three segments: the shaping segment, the transition segment (tapered) and the support segment. The material of the core determines the strength, durability and flexibility of the guide wire. It is usually stainless steel, nickel-titanium alloy or high-tensile stainless steel, etc., and runs through the entire length of the guide wire in a cylindrical shape. Stainless steel is the earliest and most commonly used guide wire core manufacturing material. It has strong hardness, good support, pushability and torque conductivity, but it has poor flexibility and is easy to wind.

The core structure is also an important factor affecting the performance of the guidewire: the thicker the core diameter, the better the support, torque transmission and pushability, and the thinner the core, the better the flexibility and tracking, but its support, torque transmission and pushability decline. The short transition section has good support, but the distal shaping section is prone to twisting, sagging, and poor flexibility and handling, while the long transition section has good torque transmission, tracking and controllability, but its support is weakened.

The tip design of the guide wire is the decisive factor in determining the controllability and flexibility of the guide wire tip. At present, there are two main methods: core-to-tip design and shaping ribbon. Design: The core direct-to-head design has good tactile feedback, pushability and tracking, and is easy to manipulate and has strong head hardness, which is suitable for high-resistance lesions and stent meshes.


Sheath design is an important factor in guidewire maneuverability and trackability, and determines guidewire visibility. Sheath is divided into coil cover (coil cover), plastic sheath (plastic cover) and polymer sheath (Polymer cover). The spring coil sheath design makes the guide wire have better tactile feedback and visibility, but increases friction, usually platinum alloy, and the length of the visible segment is 3cm; while the plastic or polymer sheath design just increases the guide wire smoothness, but reduces the tactile feedback, usually the polymer contains tungsten, and the length of the visible segment is 9-11cm, such as Boston’s PT Graphix series, Choice PT series and newly developed PT2 series guide wires, Abbott Vascular’s Pilot Series and Whisper series, Shinobi guide wire from Cordis Company and Cross NT series guide wire from Terumo Company. The current guide wire is often used in combination of multiple sheath designs to achieve the maximum performance by learning from each other.

Guidewire coatings are designed to reduce friction and increase tracking, including: hyhilic coating and hyhobic coating. Hydrophilic coating materials are mostly Pro/Pel, Hydro-track, Hydro-coat and M-coatVR, etc., which can attract water molecules to form a smooth gel on the surface of the guide wire, increasing lubricity and reducing friction. The hydrophobic coating is polytetrafluoroethylene, dihydrofluorescein and silicone resin, etc., which do not combine with water and appear waxy on the surface of the guide wire to reduce friction. In addition, they all have the characteristics of stable chemical properties, good biocompatibility and antithrombotic effect.

core to tip and shaping ribbon
  • Technology development history

The development of guide wire stems from the understanding and practice of coronary artery disease, and the development of guide wire also promotes the diagnosis and treatment of coronary artery disease. In 1979, Andreas Gruentzig performed the world’s first coronary angioplasty using a balloon, using a non-invasive guide wire fixed at the tip of the balloon, so it became the first guide wire to be used. However, such guidewires are difficult to navigate through bends, angles, calcifications, bifurcations, and severe eccentric lesions, resulting in very low balloon passage rates.
In 1982, Simpson invented the guide wire with modern significance. First, the guide wire guides the balloon to the target lesion, thereby improving the passage rate of the balloon, marking the beginning of a new era. In the past thirty years, with coronary artery disease from atherosclerotic plaque stenosis to acute thrombotic occlusive lesions formed by plaque rupture, from complete occlusion of CTO to the discovery of microchannels, guide wires have changed from From general-purpose guide wires with generalized functions to CTO guide wires with specific functions, the diameter of the tip of the guide wire becomes thinner and harder, and new combinations of coatings and sheaths are also formed to meet the different lesions and needs of CTO .
And also form CTO guide wires for different purposes, such as ultra-smooth guide wire, tip-wrapped guide wire, retrograde guide wire, RG3 guide wire specially designed for establishing externalization, Souh 03 which is more suitable for epicardium or severely tortuous side branches Guide wires and GAIA series guide wires controlled by non-tactile feedback, etc. The tip-wound guidewire is developed from the early hydrophilic coated guidewire, which is suitable for short and straight lesions with branches near the CTO, no stump and severe calcification, and is an important milestone in the history of guidewire development.

CatheterMelt manufactures guidewire tipping machine for guidewire producers. Welcome guidewire manufacturers contact us.

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