Dynamic SmartGUIDE Guidewire Enhances Neurointerventional Procedure Navigation

Wires are an essential part of neurointervention. They are often shaped outside of the body to aid in catheter navigation, however often need to be re‐shaped or replaced. The dynamic tip deflection capability of the SmartGUIDE (Artiria Medical, Geneva Switzerland) guidewire was developed to provide the operator with adaptable navigation and a novel dynamic range of wire motion while navigating through anatomy. Interventional procedures ranging from embolization of intracranial aneurysms to carotid stenting for stenosis were performed using the first and second generation 0.014” SmartGUIDE guidewire. Prospectively collected data including periprocedural complications (thromboembolic, hemorrhagic, vessel dissection or perforation) and technical success were obtained. Additionally, six features including the torque, pushability, trackability, shape retention, radiopacity and navigation of the wire were collected. Scores ranged from 1‐5, with 3 representing SmartGUIDE being comparable to a standard wire which would have been used otherwise. Ten SmartGUIDE deflectable‐tip guidewires were used in 10 neurovascular procedures including flow diversion, coiling, stenting and intrasaccular device implantation. No compatibility issues were found using a variety of 0.017”‐ 0.027" microcatheters. The wire reached the intended target in all cases (Image 1). No device‐related complications were recorded intraoperatively or at patient discharge. In all cases, the wire allowed the operator to deflect the tip and associated microcatheter to reach the respective lesion. In evaluating the Artiria microwire in comparison to the alternative guidewires available, six factors were considered and for each, SmartGUIDE was at least as good if not better (Table 1). This initial single‐center study shows the safety and versatility of the SmartGUIDE deflectable‐tip guidewire across various neurointerventional procedures. More cases are needed to explore the benefits of using SmartGUIDE effectively in practice. image image No public access funding to disclose Image 1. Artiria SmartGUIDE wire with J shape safely advanced into a superior hypophyseal artery aneurysm measuring 2.5 mm x 4.5 mm