Researchers find that a couple guidewires — BMW (Abbott) and Grand Slam (Asahi Intecc) — require less force to retrieve the OPN-NC balloon during super-high-pressure balloon percutaneous coronary intervention (PCI). Laura Novelli, MD, and colleagues from Hospital Universitari i Politécnic La Fe, in Valencia, Spain, conducted a series of tests to determine how several workhorse guidewires performed in conjunction with the OPN-NC balloon and whether certain characteristics might result in safer balloon retrieval. They presented their results in a Research Letter published online in JACC: Cardiovascular Interventions. The OPN-NC balloon (SIS Medical) is designed for use when a patient undergoing PCI has highly calcified or nondilatable lesions. With its noncompliant design, it can be inflated up to 35 atm while maintaining linear compliance, with less risk of the “dog-boning” effect. The process, however, carries a risk of guidewire entrapment and loss of distal wire position after multiple high-pressure inflations. The authors performed a bench traction test, optical micrometer dimensional guidewire evaluation and guidewire integrity verification. In all tests measuring the force required to retrieve the OPN-NC balloon, no complete entrapment was observed, and no guidewires showed coating or cover damage. However, significant differences were noted in the amount of force needed to retrieve the balloon, likely attributable to guidewire design. The guidewire that required the least amount of force, the BMW, had a uniform diameter. The guidewire that required the most force, the Sion Blue, had a thinner segment in the transition zone where the spring coil meets the shaft of the guidewire. “We believe that our results have important clinical implications, as using guidewires with a more uniform profile, such as the BMW and Grand Slam (Asahi Intecc), may reduce friction during OPN-NC balloon retrieval and enhance procedural efficiency and safety by minimizing the risk for guidewire displacement,” the authors wrote. They also recommend that in cases where guidewire friction causes distal position loss a second, parallel guidewire may be necessary for retrieval. Source: Novelli L, Sorolla Romero JA, Gil JLD, et al. Guidewire Friction Following Super-High-Pressure Balloon Percutaneous Coronary Intervention. JACC Cardiovasc Interv. 2025 Feb 19 (Article in Press). Image Credit: Damian – stock.adobe.com