Aug 2026· JNIS Advances· Vol 1, pp. e000006· 0 citations· 12 references
TL;DR
A retrospective review of endovascular procedures at a center in which the Drivewire 24 (DW24) guidewire was used, from its introduction in the authors' department in May 2024 through January 2026, identified several unique technical applications of the DW24 that represent a meaningful advancement in neurointerventional practice.
Abstract
Remotely deflectable guidewires are a recently introduced clinical tool in neurointervention. Although their efficacy and safety during early clinical use have been reported, detailed descriptions of technical nuances and advanced applications are limited.
We performed a retrospective review of endovascular procedures at our center in which the Drivewire 24 (DW24) guidewire (Rapid Medical, Yokneam, Israel) was used, from its introduction in our department in May 2024 through January 2026. Cases were screened to identify novel technical applications of the DW24.
The DW24 was used in 48 neurointerventional procedures, including mechanical thrombectomy (n=20), aneurysm treatment (n=12; 2 ruptured and 10 unruptured), dural arteriovenous fistula embolization (n=7), venous interventions (n=4), middle meningeal artery embolization (n=2), superselective cerebral angiography (n=2), and endoleak embolization (n=1). Several novel technical applications of the DW24 were identified and described in detail, accompanied by annotated procedural images.
Several unique technical applications of the DW24, enabled by the combination of its distinctive diameter and in situ deflectability, represent a meaningful advancement in neurointerventional practice. Several limitations of the DW24, compared with traditional microwires, may reflect the relatively early phase of this technology.
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BSTRACT
Endovascular neurosurgery is a branch of catheters and guidewires and understanding how they behave and function in vivo with laws of physics is utmost important for a successful vascular intervention. This technical report aims to throw light on the techniques learnt during the training programme in our institute in the scope of endovascular neurointervention with the objective to make endovascular catheter and wire handling more easy for the upcoming generations to follow and make the field of Endovascular Neurosurgery a safer territory. The guidewire (Terumo 0.035”) used in the guiding catheters is an excellent wire made up of nitinol alloy with a hydrophilic M-coating and polyurethane plus tungsten cover. The 1st technique is ‘External looping technique’ of the guidewire, which helps in tracking the guidewire into the presumed direction without the need to shift the guiding catheter face. This is based on the principle of One-piece construct with one-to-one torque transmission. The 2nd technique describes the technique of Anterior cerebral artery (ACA) cannulation in patients with small calibre ACA using a microguidewire loop and rotating the construct in the internal carotid artery (ICA) trunk while withdrawing. The 3rd technique explains the technique of microcatheter loop inside the giant aneurysms for tracking into the distal vessel for Flow diverter or stent-assisted coiling techniques, which is based on the principle of inherent straightening tendency of the microcatheter.
A. Rajput, Shaam Bodeliwala· Journal of Cerebrovascular S...· 0 citations
BACKGROUND
Retrograde tibial-pedal access is a well-established technique for managing peripheral arterial occlusive disease and its associated ischemic symptoms. While generally considered safe and effective, this method presents notable challenges due to the small caliber and, often, diseased nature of the target vessels, which can complicate entry and cannulation. As a result, multiple access attempts may be necessary, and access-related complications can hinder or even prevent a successful percutaneous intervention.
AIMS
This report aims to describe a single-center experience utilizing a novel access guidewire featuring a small core diameter and an articulating tip to facilitate tibial-pedal access.
METHODS
Patients with peripheral vascular disease in whom tibial-pedal access was attempted between January 2, 2024 and September 15, 2025 were included. Real-time ultrasound guidance was used in all cases. Post-procedural ultrasound was performed after hemostasis was achieved with manual compression to evaluate the accessed vessel patency and rule out complications. Study outcomes were first-attempt and overall guidewire insertion success, post-procedural and 30-day patency of the accessed vessel on ultrasound, and incidence of access site complications.
RESULTS
Records of 167 access procedures attempted in 133 patients were reviewed (left anterior tibial-76, right anterior tibial-71, right posterior tibial-7, left posterior tibial-4, left dorsalis pedis-1). First-attempt success was 98% (154/157 evaluable records) and all-attempt success was achieved in 100% of the cases. There were no access-site complications, such as occlusion, extravasation, or pseudoaneurysm. Patency was confirmed in all accessed vessels immediately following the procedure and maintained in all but one case at the 30-day mark.
CONCLUSIONS
Tibial-pedal access was successfully obtained in all cases, demonstrating an exceptionally high nominal first-attempt success rate and no peri-procedural complications. In conjunction with preserved post-procedural vessel patency, these findings support the articulating-tip guidewire's safety and effectiveness for its intended application.
Ashwani Sastry, Sreejit Nair· Catheterization and cardiova...· 0 citations
Background Endovascular recanalization of non-acute internal carotid artery occlusion (NA-ICAO) remains technically challenging. This technical report describes the Balloon-Assisted Catheter Advancement (BACAT) technique and evaluates its procedural feasibility in a small, heterogenous patient cohort. Methods We retrospectively reviewed 15 patients with NA-ICAO who underwent BACAT-assisted recanalization. Cases included both pure endovascular therapy (n = 8) and hybrid therapy combined open surgery with endovascualr therapy (n = 7). The primary outcome was technical success, defined as successful antegrade passage of the catheter across the occlusive segment using the BACAT maneuver. Procedural complications were recorded descriptively. Results Technical success was achieved in 13 of 15 patients (86.7%). No intraprocedural rupture or flow-limiting dissection occurred. One non-disabling postoperative stroke (6.7%) was observed in the hybrid subgroup. Given the small sample, absence of a control group, and case heterogeneity, no statistical comparisons or efficacy claims are made. Conclusions The BACAT technique appears technically feasible for selected patients with NA-ICAO, including both pure endovascular therapy and hybrid surgical. This report provides procedural details to facilitate replication and further investigation. Clinical efficacy and comparative safety require validation in larger, controlled studies.
Yufeng Wang, Yixin Sun, Ruilin Ren et al.· Frontiers in Surgery· 0 citations
Objective The Tubridge Plus flow diverter (TPFD) is an iterative evolution of the previous Tubridge flow diverter (TFD) with enhanced technical features intended to overcome prior limitations. This single-center prospective study reported our preliminary experience using the TPFD for intracranial aneurysms (IAs), with evaluation of its technical feasibility, efficacy, safety, and outcomes. Methods Between May and July 2023, 10 consecutive patients with 10 IAs were enrolled and treated with TPFD in our institution. Technical success, intraoperative adverse events, angiographic outcomes were collected and analyzed. Results Technical success rate for TPFD delivery and deployment was 100%. Intraoperative adverse events, consisting of distal malapposition and iatrogenic proximal malapposition, occurred in 2 patients (20%), both successfully rescued with adjunctive stenting. No perioperative complications occurred, and only 1 patient (10%) experienced transient postoperative headache as a result of mass effect. Angiographic follow-up (FU) demonstrated that complete occlusion rates (OKM D at 6 months; RROC I at 1 year and last FU) improved progressively over time: 60% at 6 months, 80% at 1 year, and 90% at the last FU, with adequate occlusion rates of 90 and 100% at 1-year and the last FU, respectively. No in-stent stenosis or ipsilateral stroke was recorded in any patient during the entire FU period. Conclusion This prospective single-center preliminary experience in 10 patients suggests that TPFD is technically feasible, safe, and effective for the endovascular treatment of unruptured ICA aneurysms. However, given the small sample size and single-center design, further large-scale, multicenter studies with long-term FU are warranted to validate its safety and efficacy as a next-generation flow diverter.
Tao Zhang, Xing Guo, Yufeng Liu et al.· Frontiers in Neurology· 0 citations
Fiber Optic RealShape has an acceptable technical success rate in visceral TV catheterization during cEVAR, which has improved following the 3D-Hub implementation, supporting initial FORS use in all catheterizations to minimize radiation.
Charlotte C. Lemmens, B. Mees, M. Vleugels et al.· Journal of Endovascular Ther...· 0 citations