The Triple-Wire Technique for Delivery of Endovascular Components in Difficult Anatomy. Annals of vascular surgery Stern, J. R., Cheng, C. P., Colvard, B. D., Paranjape, H., Lee, J. T. 2020


We describe a novel endovascular technique in which three 0.014" guidewires are placed in parallel through a 0.035" lumen catheter, in order to create a stiff platform to allow for delivery of 0.035" profile devices through challenging anatomy. Three illustrative cases are presented: a difficult aortic bifurcation during lower extremity intervention, a tortuous internal iliac artery during placement of an iliac branch device, and salvage of a renal artery after inadvertent coverage during proximal cuff deployment for type 1a endoleak. We also quantify the relative stiffness of the triple 0.014" wire configuration, using several well-known 0.035" wires for comparison. The "triple-wire technique" is an effective method for tracking endovascular devices through difficult tortuous anatomy, and can be used in a variety of clinical settings. The technique is especially useful when a traditional, stiff 0.035" wire will not track without "kicking out." Each 0.014" wire is reasonably soft and traverses the tortuous vessel easily, but when the three wires are used together as a rail it provides a stiff enough platform for delivery.

View details for DOI 10.1016/j.avsg.2020.04.021

View details for PubMedID 32335254