Guidewires are used to steer central venous catheters to a target site of the vascular system. They are essential components of minimally invasive surgeries and have been used alongside catheters for over 100 years. Due to the high success rates and low complications associated with these procedures, guidewires will continue to be a mainstay of minimally invasive surgery for many years to come.
Unsurprisingly, there are hundreds of guidewires on the global medical device marketplace, with many designs tailored to highly specific applications and anatomical regions.
In 2023, guidewire innovation is not slowing down. To further improve patient outcomes and make complex anatomies easier and safer for surgeons to access, medical device developers are exploring several new design concepts. Meanwhile, existing industry trends such as rising use of nitinol continue to gather pace.
1. Nitinol core wires and hybrid designs
Nitinol, an alloy of nickel and titanium, has become one of the preferred materials for guidewire cores. While stainless steel continues to be the standard, the demand for nitinol has risen quickly, according to John Corsten, head of sales at medical wire specialists Custom Wire Technologies.
“In the past five years, it’s really gained traction to where we’re processing nitinol daily. It will never take over stainless steel, but I see the demand increasing and innovative devices being developed centred around nitinol,” Corsten said in a previous interview.
There are a few reasons behind the alloy’s popularity. Most important is nitinol’s elasticity, which provides greater flexibility and kink resistance to the device – a key benefit in guidewires designed to deal with tortuous pathways.
First introduced by Boston Scientific, hybrid guidewires combine the benefits of a PTFE-coated nitinol core wire with a softer, flexible hydrophilic tip for atraumatic access to tight areas. In urology, hybrid wires are often used for the placement of stents and sheaths.
2. Sensors and fibre optics
In most catheterisation procedures, guidewires enter the vascular system through a safe access point and are steered through branched or tortuous vessels to a target site relatively far from the original entry point. X-ray systems are used to obtain real-time intravascular images. Operators may also rely on tactile feedback from the guidewire (particularly coil-tipped wires) to better gauge its position. Nevertheless, it can be a challenge for clinicians to precisely position the guidewire under X-ray, especially when vessels are completely occluded.
It is no surprise that the next big innovation in guidewire designs seeks to solve this. Companies are experimenting with incorporating microsensors and fibre optics into the tip of the guidewire, providing more accurate, real-time feedback to operators. According to GlobalData, these smart designs are currently being tested in clinical trials. If successful, ‘sensorised’ wires are expected to boost the size of the guidewire market significantly.
Corsten comments: “CWT has experience working with grooved wire. The grooved area is where the fibre optics are being embedded. We are still in the R&D phase for several projects. It’s just a matter of time before this technology goes to the next level, assuming it can be cost-competitive in the marketplace.”
3. Robotically steerable guidewires
Robot-assisted surgery is already a major trend in minimally invasive surgery, and engineers are naturally looking at ways it could be extended to guidewires and catheters to improve the safety, accuracy, and repeatability of catheterisation.
At a Massachusetts Institute of Technology (MIT) event in 2022, researcher Yoonho Kim presented the Robo-thread guidewire, a robotic device made from nitinol. Robo-thread can be steered magnetically as part of highly advanced neurosurgery procedures such as stroke and aneurysm interventions.
In 2021, a team of researchers from Atlanta, Georgia, published a proof-of-concept for a robotically steerable guidewire with forward-viewing ultrasound imaging, designed to enable navigation through occluded vessels that are unable to be crossed with traditional methods.
Over the next few years, more developments are expected in this field, but there may be a long way to go before a robotic guidewire reaches the market.
Your dedicated partner for guidewire innovation
Based in the US, Custom Wire Technologies (CWT) is a leading provider of custom-designed medical wire components, with years of experience coiling and grinding for many applications, including guidewires. CWT has experience serving customers both large and small and is committed to delivering premium service with fast lead times whatever the requirement.
When designing prototypes of innovative guidewires that have never been seen before, it’s natural to encounter challenges, but a custom coil or unique grind profile could be the answer. To learn more about how CWT helps companies deliver on innovative guidewire designs, download the whitepaper below.