The idea for this editorial emerged in my mind while reviewing the article “A Comparison of Interventional Guidewires in a Canine Model” by Huang et al. The authors set out to test three different wires in the setting of an in vivo experiment. They used some of the most common maneuvers interventionists perform with guidewires in the course of endovascular procedures. Not surprisingly, the study showed the superiority of the GlideWire. I thought it was reassuring — at least to me!
And now the rest of the story; and it’s all personal. As a vascular surgeon daring to begin an interventional practice in late 1987, I came across the GlideWire for the first time. It was a brand new and revolutionary device then. In those early days, some physicians were already claiming the ability to “easily” traverse total occlusions… even very long ones in the superficial femoral artery. “Slippery wire,” “eel-wire” and the like were names often used, as it seemed unstoppable with its crossability and deliverability prowess. And, in fact, I was able to confirm this in my own hands in 1988 when I began the initial personal experience with endovascular recanalization of superior femoral artery occlusions. Instantly, I became a believer!
As my endovascular experience mounted and gradually evolved over the years, the GlideWire came to occupy a definite and important place in the armamentarium. It was (and is) the tool I often resorted to in a variety of situations: for access across difficult iliac arteries, to select branches in certain anatomical settings, to traverse total occlusions; and when nothing else would work! None of this has changed. But, it is also appropriate to insert a word of caution; this is a wire that can easily slip into unwanted branches and locations, and even perforate vessels or the renal parenchyma with little effort. And its outer coating can be stripped off the core by the sharp, beveled end of a Potts needle, upon unwise attempts at pulling the wire out.
With those thoughts in mind, I felt it would be of interest to the VDM readership to build this Editor’s Corner on the foundation of such an amazing and seemingly simple device. Although classified as a “wire,” in truth, it is not a wire atall. Rather, it features a multi-layer composite construct (Figure 1) that explains the most unique characteristics and capabilities we have come to expect from the GlideWire. Its history is probably unknown to most users today:
• Developed by the Terumo Corporation (Japan) in the 1980s;
• Launched in the U.S. on March 27, 1987 and sold initially by specialty distributors and direct sales;
• Distributed exclusively in the USA through Medi-Tech (BSC) beginning in 1989;
• Various iterations were developed and launched over the years, including the GlideWire Gold, GT Wire, Headliner, and Crosswire;
• Agreement with BSC ended March 31, 2006 when Terumo took over direct sales of the GlideWire product line.
As we are all aware, several leading endovascular companies have tried to develop a product that would duplicate, or at least approximate, the capabilities of the GlideWire — some more than once! None has succeeded. I have myself tried a few of these so-called “glidewire-like” wires over the years and appreciated, firsthand, just how difficult, (if not impossible), it must be to duplicate or improve on a device that has obviously endured the test of time and competition. Perhaps one day somebody somewhere will achieve such feat, but I would not hold my breath! Until then, I will maintain the long-held belief that the GlideWire constitutes an amazing tool that continues to display unparalleled performance 20 years after it was first introduced in the U.S. market.