BackTable / VI / Podcast / Episode #279
Dissecting Wire Senses
with Dr. Hady Lichaa
In this episode, host Ally Baheti interviews interventional cardiologist Dr. Hady Lichaa of Ascension St. Thomas Heart about wire senses, including ways to build tactile and visual skills, selection of workhorse and specialty wires, and the do’s and don’ts of crossing lesions.
BackTable, LLC (Producer). (2023, January 6). Ep. 279 – Dissecting Wire Senses [Audio podcast]. Retrieved from https://www.backtable.com
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Dr. Hady Lichaa
Dr. Hady Lichaa is an interventional and general cardiologist with Ascension Saint Thomas Heart in Tennessee.
Dr. Aparna Baheti
Dr. Aparna Baheti is a practicing Interventional Radiologist in Tacoma, Washington.
Dr. Lichaa starts by outlining four different components of wire senses: visual sense, tactile sense, IVUS, and the digital subtraction angiography (DSA) roadmap. First, visual aspects are a combination of 2D wire sliding and looping, 3D rotation, and the course of the wire relative to the vessel architecture. By combining these visual cues, the operator can determine if the wire is inside the true lumen, within the vessel wall, or entirely outside of the vessel.
The next factor is tactile sense. Each type of wire strikes a balance between resistance to rotation / advancement and torque transmission. This balance is determined by wire characteristics such as core material, tapers, tip design, and coating. Dr. Lichaa encourages operators to test out different wires and focus on mastering their favorite workhorse wires. Additionally, there are specialty wires that can be employed in certain cases, such as CTO wires with heavy tip, tapered tip wires to enter microchannels, and supportive wires for the use of other equipment.
Additionally, we discuss how intravascular ultrasound (IVUS) leads to safer outcomes because it allows the operator to confirm that they are in the true lumen and measure vessel size before deploying stents or balloons. DSA can also help determine location and help map out different strategies if a first option fails.
Finally, Dr. Lichaa lists some helpful tips for new operators. We highlight the importance of mastering your favorite wires, having backup plans, communicating with staff, and keeping calm in the angio suite.
Abbott Command Wire:
ASAHI Gladius Wire:
ASAHI CONFIANZA Pro:
Terumo NAVICROSS Support Catheter:
Teleplex Turnpike Catheter:
ACT ONE Technology:
Philips Pioneer Reentry Catheter:
Cordis OUTBACK Reentry Catheter:
Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.