RT Book, Section A1 Abbott, J. Dawn A1 Williams, David O. A2 Samady, Habib A2 Fearon, William F. A2 Yeung, Alan C. A2 King III, Spencer B. SR Print(0) ID 1146598198 T1 Coronary Guidewire Manipulation T2 Interventional Cardiology, 2e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9780071820363 LK accesscardiology.mhmedical.com/content.aspx?aid=1146598198 RD 2024/11/10 AB Appropriate selection and manipulation of equipment is critical to successful percutaneous coronary intervention (PCI) outcomes and low complication rates. The guidewire is the first piece of interventional equipment to contact the lesion to be treated. Proper intraluminal advancement of the guidewire through the lesion and into the distal vessel allows the coronary guidewire to serve as the backbone for the safe delivery of diagnostic and therapeutic devices while maintaining secure and safe access to the vessel lumen. Although the current standard 0.014-inch wires are suitable for the majority of interventions, operator familiarity and facility with guidewire selection and manipulation are still paramount. The advent of specialty guidewires, such as those designed for chronic total occlusions (CTOs), has furthered our ability to successfully treat more complex lesions, but the use of these wires requires an understanding of specific wire performance features and the possible complications that can result from their use. Given the wide variety of guidewires that are available, knowledge of their design, materials and structure aids the operator in understanding unique differences in performance and ultimately in making the proper selection for an individual patient or lesion.