Abstract 317: The Drivewire24 steerable guidewire in neurovascular procedures: initial multicenter clinical experience, literature review, and novel applications
Notice bibliographique
Résumé
Introduction/Purpose To evaluate the first in‐human multicenter clinical experience with the Drivewire24 (DW24)—a novel mechanically‐adjustable steerable guidewire—in neurovascular interventions, review the current state of literature, and explore potential future applications. This 0.024 inch, 204 centimeter second‐generation steerable guidewire allows the operator to precisely select vessels by deflecting and shaping the tip in situ using a torque‐like rotational handle. Materials and Methods A non‐consecutive retrospective series of 176 patients who underwent neurovascular procedures involving DW24 use at four North American academic institutions between April 2024‐August 2025 was analyzed. Patient selection for DW24 use was determined preoperatively or intraoperatively at the discretion of the performing interventionalists based upon technical suitability, anatomic, and procedural considerations. Mean patient age was 62.8 years (range 19‐98, SD=14.8), with 74 males (42.0%) and 102 females (58.0%). Treatment indications included ischemic stroke (n=71, 40.3%), aneurysm (n=57, 32.4%), diagnostic cerebral angiogram (n=16, 9.1%), middle meningeal artery embolization (n=7, 12.3%), and other (n=25, 14.2%). Vascular access was via femoral artery (n=86, 48.9%), radial artery (n=74, 42.0%), both femoral and radial artery (n=6, 3.4%), femoral vein (n=5, 2.8%), and other sites (n=5, 2.8%). The DW24 was used as the sole access wire in 48.9% of cases (86/174), or in conjunction with one (38.1%; 67/174) or more (11.9%; 21/174) wires. Outcomes assessed included procedural access success, device malfunctions or failures, and procedural complications. Results The Drivewire24 successfully reached the target vessel(s) in 166/176 patients (94.3%), with partial success in 2 cases (1.1%), but was unsuccessful in 8 cases (4.5%). In cases where DW24 failed, another wire successfully achieved vessel access in 6 of 8 instances (75%). Overall, vessel access was achieved with any wire in 98.3% (173/176) of cases, and operators rated the DW24 wire as easy to use in 96.0% (169/176) of cases. Interestingly, in 20 cases (11.4%), operators deemed the DW24 as essential for successful vessel access, even though other wires were trialed in only 15 of these 20 cases. Intraoperative complications occurred in 5.1% of cases (9/176), including subarachnoid hemorrhage (1.1%; 2/176), microperforation (0.6%; 1/176), thromboembolism (0.6%; 1/176), dissection (0.6%; 1/176), and coil extrusion (0.6%; 1/176). However, no complications were directly related to DW24 use, and there were no DW24‐associated vessel perforations or hardware issues. Conclusion The Drivewire24 is a safe and effective mechanical steerable neurovascular access wire with several advantages over conventional guidewires, including adaptive tip conformation for accurate and efficient vessel selection, as well as excellent catheter anchoring and support. Beyond improving access in complex cases with difficult anatomy, promising novel uses of the DW24 for microcatheter deflection and in situ device manipulation remain to be explored in further clinical applications
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».