Double Concentric Guidewire for CTO Crossing
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Solution Overview
Problem
Current guidewires for crossing chronic total occlusions (CTOs) in arteries are cumbersome and inefficient, requiring multiple guidewires with varying stiffness and curvature, which increases procedure time, x-ray exposure, and risk of vessel perforation.
Innovation Solution
A double guidewire system comprising a hollow outer guidewire with a deflectable helical coil and an inner guidewire deployed within the outer guidewire, allowing for adjustable stiffness and curvature by an adjuster mechanism, enabling precise navigation through CTOs.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Adaptability or versatility
If multiple guidewires with varying stiffness and curvature are used to cross CTOs, then the ability to navigate different vessel geometries is improved, but the procedure time increases and the complexity of the intervention increases
Solution Approach 1:
The patent combines multiple guidewire functionalities into a single device by integrating an outer guidewire with a hydrophilic coating and a inner guidewire with a stiffer tip within the same system. This allows the operator to switch between different guidewire characteristics (floppy vs. stiff, coated vs. uncoated) without removing and replacing entire guidewires, thereby reducing procedure time while maintaining the ability to navigate various vessel geometries and cross CTOs effectively.
Solution Approach 2:
The inner guidewire is nested within the outer guidewire, creating a concentric structure where the smaller guidewire can be advanced or retracted relative to the outer one. This nested configuration enables the operator to deploy the stiffer inner guidewire when needed for crossing tight CTO segments, while the outer guidewire remains in place, eliminating the need to withdraw and replace the entire guidewire system and thus reducing procedure time.
2Adaptability or versatility
If multiple guidewires with varying stiffness and curvature are used to cross CTOs, then the ability to navigate different vessel geometries is improved, but the device complexity increases
Solution Approach 1:
The patent merges multiple guidewire functionalities into a single integrated system where the outer guidewire and inner guidewire work together. This consolidation reduces the number of separate devices needed, simplifying the overall system while maintaining the ability to adapt to different vessel geometries through the adjustable configuration of the nested guidewires.
Solution Approach 2:
The system incorporates dynamic adjustability where the inner guidewire can be advanced or retracted relative to the outer guidewire, allowing the operator to change the effective stiffness and tip characteristics of the combined system. This dynamic configuration capability provides versatility in navigating different vessel geometries without requiring multiple fixed-configuratio
Data Source
AI summary
A double guide wire includes two guidewires deployed concentrically, one within the other. Each guidewire is formed as an elongated flexible shaft having a distal portion including a deflectable helical coil terminating at a distal tip. The first guidewire is implemented as a hollow guidewire having a central lumen extending along its length, while the second guidewire is configured as a smaller gauge guidewire deployed within the central lumen of the first guidewire. An adjuster mechanism allows the inner guidewire to be advanced and retracted relative to the outer guidewire, transforming the guidewire between: a first state in which the distal tip of the second guidewire is adjacent to the distal tip of the first guidewire; and a second state in which at least part of the distal portion of the inner guidewire is advanced beyond the distal tip of the first guidewire.