| Summary: | Purpose Practical challenges are encountered in percutaneous intravascular procedures when applied
to markedly angulated branching vessels. Herein, we introduced a folded-loop guidewire remodeling
technique–the guidewire-shaping technique–to overcome difficult catheterization.
Materials and Methods First, the tip of a 0.014-inch micro-guidewire was manually shaped like a
pigtail loop. Second, the shaped guidewire was introduced into the microcatheter and was preloaded
into the hollow metal introducer for suitability with the microcatheter hub. Gentle rotation of the
guidewire after release from the microcatheter can create the preshaped pigtail loop configuration.
On pulling back, the loop loosened, the configuration was changed to a small U-shaped tip, and the
guidewire tip was easily introduced into the target artery.
Results Between December 2019 and January 2022, the described technique was used in 64 patients
(male/female, 49/15; mean age, 66.8 ± 9.5 years) for selective arterial embolization, after failed attempts
with the conventional selection technique. The technique was successful in 63/64 patients (98%). The
indications of embolization include transcatheter arterial chemoembolization, gastrointestinal bleeding,
hemoptysis, trauma-induced bleeding, and tumor bleeding. Conclusion The folded-loop guidewire remodeling technique facilitates the catheterization of markedly
angulated branching arteries; when usual catheterization method fails.
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