Author + information
- Deborah Kalkman1,
- Huangling Lu2,
- Nicole van der Wel3,
- Henk van Veen4,
- Jan Tijssen5,
- Robbert de Winter4 and
- Maik Grundeken1
Hydrophilic coatings are currently used on numerous devices in endovascular interventions, e.g. microcatheters, guidewires and guiding sheets. These hydrophilic coatings provide a lubricious, low-friction layer to prevent vessel dissection, when manoeuvring through the vessels. However, numerous case reports on the finding of foreign material emboli after endovascular intervention in humans have been published, which could possibly lead to thrombotic complications. The exact source of these foreign materials is unknown. We aim to evaluate surface integrity of the hydrophilic coating of a coronary guide wire in unused and used state.
We conducted an observational imaging study with scanning electron microscopy (SEM) to assess the surface of the last 5cm from a commonly used guidewire A) one unused ‘control’ guide wire, unpacked just before SEM, B) one unused guide wire, unpacked and manually manipulated with a latex glove and water, ‘semi-control’ and C) one used guide wire, used in a patient during a percutaneous coronary intervention.
SEM images are shown in figure 1. Image A and D show the control guide wire, B the semi-control and C and E are the guide wire used in a patient. The surface of the guide wire tip used in a patient seems irregular, and a possible tear is observed on this guide wire, indicated with the white arrow.
Scanning electron microscopy evaluating a coronary guide wire in used state shows irregularities of the surface. These irregularities could possibly lead to foreign body embolization.
CORONARY: Thrombus / Thrombectomy and Embolic Protection