

Episode # 373 • 09 Oct 2023
Sharp Recanalization Using the RF Wire
In this episode, host Dr. Ally Baheti interviews Dr. Marcelo Guimaraes about using radiofrequency wires for sharp recanalization. Marcelo is an interventional radiologist at the Medical University of South Carolina and founder of the 2009 Sniper technique.
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Marcelo begins by telling us about the Sniper technique, what RF wires are, and how they are used in sharp recanalization. He provides indications for using RF wires and his general workup and intraoperative flow for recanalization interventions. Marcelo also discusses the use of RF wires for iliocaval occlusions, SVC/upper extremity occlusions, and chronically occluded stents.
Marcelo gives a comprehensive explanation of how and why the Sniper technique has evolved over the years. We also cover RF wires’ capabilities in crossing particularly, long occluded segments and the importance of cone-beam CT in complex cases. Ally and Marcelo then discuss applications of IVUS in sharp recanalization.
Marcelo also shares his thoughts on possible alternatives to the RF wire and speaks about current and future applications of RF wires in non-vascular cases. Marcelo ends the episode by sharing tips on how to avoid unfavorable outcomes when using an RF wire, which includes his caution against using the Sniper technique in the office-based lab (OBL) setting.
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