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Record W4416921473 · doi:10.1161/svi270000_317

Abstract 317: The Drivewire24 steerable guidewire in neurovascular procedures: initial multicenter clinical experience, literature review, and novel applications

2025· article· en· W4416921473 on OpenAlexaff
Alan R. Rheaume, Е. Н. Гринь, O.P. Gandhi, Zeev Itsekzon Hayosh, S. R. Dumasia, Erez Nossek, Pascal J. Mosimann, O. Choudhri, Jeremy Rempel

Bibliographic record

VenueStroke Vascular and Interventional Neurology · 2025
Typearticle
Languageen
FieldMedicine
TopicVascular Procedures and Complications
Canadian institutionsUniversity of TorontoUniversity of Alberta
Fundersnot available
KeywordsNeurovascular bundleRadial arteryEmbolizationAneurysmFemoral arteryMiddle cerebral arteryStroke (engine)

Abstract

fetched live from OpenAlex

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

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.268
Threshold uncertainty score0.602

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.018
GPT teacher head0.351
Teacher spread0.333 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations0
Published2025
Admission routes1
Has abstractyes

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