What are the medical nickel-titanium guidewire processing technologies?

What are the medical nickel-titanium guidewire processing technologies?

Processing guidewires is more challenging than handling catheters. For vascular intubation, it’s best to use the original, new guidewires. For intubation of body cavities other than blood vessels, shorter guidewires with varying bending angles are required; these can be crafted from discarded guidewires that have been deformed during vascular procedures. So, what are the medical nickel-titanium guidewire processing technologies?

What are the medical nickel-titanium guidewire processing technologies?

1. Shaping: Cut off both ends of the discarded guidewire, pull out the steel wire core, leaving behind the soft spring basket. When shaping, hold the spring basket in one hand to let it air dry, while using hemostatic forceps in the other hand to gently clamp the spring’s end—this will cause it to collapse. Bend the tip into your desired shape. Alternatively, you can use the guidewire itself as a raw material to create various types of wire coils for vascular embolization.

2. After the steel reed is welded into shape, file one end of the 510 cm steel wire core into a tapered, slender wire, or flatten it on an anvil and trim it appropriately. Insert the shaped end into the irregular end of the spring, aligning the slender tip with the reed, then weld the two parts together and smooth the weld area. Finally, cut the reed to the desired length and weld its end to the steel wire core.

What are the cleaning methods for medical nickel-titanium guidewires?

1. Guidewires are more fragile instruments than catheters and can easily become kinked or damaged if not handled carefully. Stocked guidewires should be stored either straight or coiled into large loops. Ensure the wires are kept in a dry, well-ventilated area and avoid any connections.

2. Avoid contact with acids, bases, or salt-containing substances and solutions. Before use, each guide wire must be carefully inspected for damage—especially the flexible tip—and thoroughly rubbed to check for any defects. Since acidic liquids are used to weld the tips of the guide wires, these substances can penetrate the wires and become extremely difficult to clean. Over time, this corrosion will weaken the spring basket, compromising its structural integrity.

3. Therefore, any reusable guidewire should be immediately immersed in heparin solution after use. After wiping, rinse thoroughly with running water, then air dry, and finally sterilize for future use.

What are the common issues with medical nickel-titanium guidewires?

1. Gentle movements:

The guidelines require that the guidewire be gently advanced throughout the procedure; forceful pushing should be strictly prohibited when resistance is encountered, as this could cause the guidewire to enter a branch vessel, leading to complications such as hematoma—and there have even been documented cases where a guidewire inadvertently punctured a carotid plaque by entering the carotid artery, resulting in cerebral infarction.

2. In actual operation, is it fully transparent?

In practice, we typically don’t use full透视; instead, we first guide the guidewire to the subclavian artery and then proceed with fluoroscopy. However, it’s important to emphasize that this approach works only when the guidewire can be advanced smoothly, without any resistance. Some experienced practitioners may choose to direct the guidewire straight to the sinus base for fluoroscopic visualization—this method feels effortless and shows no resistance—but I wouldn’t recommend it, as it could inadvertently lead the guidewire into the carotid artery, potentially resulting in serious complications.

3. The guidewire got stuck in the radial artery, and no matter how many times we tried adjusting its direction, it wouldn’t advance further.

At this point, we can withdraw the guidewire and angiographic catheter from the arterial sheath and perform radial artery angiography through the arterial sheath.

4. The guidewire consistently enters the descending aorta instead of the ascending aorta:

(1) Instruct the patient to take a deep breath, hold their breath, and adjust the guidewire's direction to facilitate its advancement into the ascending aorta.

(2) Secure the guidewire, advance the angiographic catheter into the aorta, and then retract the guidewire back into the catheter. At this point, the forward bend of the catheter tip can spring into the ascending aorta, allowing you to guide the guidewire further toward the sinus base.