Catheters and stents can only travel through the body’s narrow passageways with the assistance of guidewires. Long, thin, and flexible, these wires steer the device to the desired location within the vascular system.

During percutaneous transluminal angioplasty (PTA), peripheral guidewires are used to direct stents or balloon catheters to the location of the blockage in the peripheral vasculature.

Such guidewires are crucial components of minimally invasive surgeries. Featuring high success rates and minimal risk in these procedures, they have already been in usage alongside catheters for over a hundred years and look set to continue this success for many years to come.

Peripheral guidewires market

Analysis shows that an aging population is driving the use of minimally invasive procedures, and this is reflected in the peripheral guidewires market.

Research from GlobalData shows that the peripheral guidewires market size was valued at US$1.09 billion in 2022 and is expected to continue to grow with the prevalence of peripheral arterial disease (PAD), a common condition where a build-up of fatty deposits in the arteries restricts blood supply to leg muscles (also known as peripheral vascular disease).

Hydrophilic peripheral guidewires led the market in 2022. These wires have a hydrophilic coating that provides lubrication to facilitate catheter navigation. Non-hydrophilic peripheral guidewires can incorporate other coatings such as polytetrafluoroethylene (PTFE) or silicone.

Key regions for peripheral guidewires include North America, Europe, Asia Pacific, the Middle East and Africa. On a country level, the US, Canada, and Mexico observe slower growth in lower extremity PAD prevalence numbers. Analysis suggests that this is due to the adoption of a better lifestyle, with efforts to educate patients about warning signs and symptoms, and adoption of alternative treatment options such as medication.

Device selection and usage

Guidewires consists of a metal core with an outer wire. The flexibility of the core wire depends on its diameter and length, with a thinner diameter having more flexibility while a larger diameter provides more support. In terms of length, longer designs will cause more flex within the wire than shorter ones, which retain more stiffness. Stiffness of the guidewire is also determined by the constituents that make up its metal core.

Peripheral guidewires are often used to assist angiography and angioplasty catheters to reach the affected site in the peripheral artery. Factors such as the indication/lesion of interest, tip design, stiffness, torque, manoeuvrability, calibre, and lubricity of the guidewire, all play important roles in guidewire selection. In combination, these factors enable the selection of the most appropriate guidewire, which can determine the success of the angiography or angioplasty procedure.

For example, arteries below the knee are small and complex and usually require guidewires with a smaller calibre, affording higher flexibility to the guidewire. In contrast, guidewires with a larger calibre provide better torque control.

The hydrophilic or non-hydrophilic coating is another important criterion for the guidewire selection. While non-hydrophilic coatings provide better trackability and reduce the risk of vessel perforation, hydrophilic guidewires are easier to guide.

Dedicated partner for guidewire innovation

Custom Wire Technologies (CWT) is a leading supplier of custom designed medical wire components. The company works with both large and small customers, with years of experience coiling and grinding medical wire components for many applications, including guidewires.

CWT’s range of peripheral guidewires includes various materials for outer coil and core areas, each with its own engineering advantage. Common materials include 304V, 316LVM, nitinol, platinum iridium, platinum tungsten, and tungsten (gold-plated optional).

A variety of guidewire tips are also available, including straight, angled and J-tips as well as shapes that can be modified by the operator during usage.

“Our customers lean on CWT when off-the-shelf guidewires aren’t yielding the results they hoped for,” says John Corsten, technical sales manager at CWT. “Being able to offer customised solutions, whether it be a coil and/or a core wire, CWT plays a vital role from the concept phase all the way through to production.”