Guidewire Manipulation Based on Establishment of Stereo Perception in Percutaneous Coronary Intervention - Clinical Science

Q: What problem does the study address in percutaneous coronary intervention (PCI)?

PCI traditionally relies on two-dimensional X-ray imaging, which provides limited depth perception and makes it harder to determine true/false lumen relationships and the direction of guidewire rotational torque.

Q: How is stereoscopic perception established during coronary angiography (CAG)?

The approach uses digital subtraction angiography (DSA) with gantry rotation combined with UG NX simulation to determine guidewire tip orientation and the relative positions of the true lumen and false lumen.

Q: What evidence supports the effectiveness of the new guidewire manipulation method?

Results showed accurate determination of guidewire tip orientation and true/false lumen positions, consistent rotational torque behavior within the coronary lumen, and a higher success rate after training in a 3D-printed heart model trial (93.3% vs. 60%, p < 0.01).

Sep 29, 2026

Uploaded by Emma Wilson

Traditional percutaneous coronary intervention (PCI) depends on two-dimensional X-ray imaging, which limits depth perception and makes precise guidewire manipulation difficult. This study proposes a stereoscopic-perception method in coronary angiography (CAG) to improve precision and success rates. Using DSA with gantry rotation and UG NX simulation, researchers assessed guidewire tip orientation and true/false lumen relationships, verified with a 3D-printed heart model, and evaluated directional accuracy after training.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

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Abstract

Background

Methods

Results

Conclusion

Introduction

Catheterization and Cardiovascular Interventions ORIGINAL ARTICLE ‐ CLINICAL SCIENCE Guidewire Manipulation Based on Establishment of Stereo Perception in Percutaneous Coronary Intervention Miao Chen1 | Huiqiang Zhao2 | Xiantao Song2 1Department of Emergency, Beijing Friendship Hospital, Capital Medical University, Beijing, China | 2Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China Correspondence: Huiqiang Zhao ([zhaohq05@aliyun.com](zhaohq05@aliyun.com)) | Xiantao Song ([song0929@mail.ccmu.edu.cn](song0929@mail.ccmu.edu.cn)) Received: 5 June 2025 | Revised: 11 October 2025 | Accepted: 21 October 2025 Funding: The authors received no specific funding for this work. Keywords: 3D wiring techniques | coronary angiography | coronary artery disease | percutaneous coronary intervention | stereo perception ABSTRACT Background: Traditional percutaneous coronary intervention (PCI) relies on two‐dimensional X‐ray imaging, but this does not allow depth perception and complicates precise manipulation of the guidewire. Our purpose was to develop a novel method for guidewire manipulation by establishing stereoscopic perception in coronary angiography (CAG), as described in our previous study, and thereby improve the precision and success rate of PCI. Methods: Based on establishment of stereo perception in CAG, we used digital subtraction angiography (DSA) with gantry rotation and simulation with UG NX software to determine the orientation of the guidewire tip and the relative positions of the true lumen and false lumen. We then performed verification using a highly realistic 3D‐printed transparent silicone model of the human heart and coronary arteries. By manipulating the guidewire in various branches of the model of the coronary artery, we identified the directional torque of wire rotation and simulated this using UG NX software. A preliminary trial with unidirectional rotation was conducted in which one interventionist performed 60 guidewire manipulations (30 before and 30 after training) in a 3D‐printed heart model to quantify changes in directional accuracy. Results: The results confirmed that the orientation of the distal tip of the guidewire and the relative positions of the true and false lumens were accurately determined using DSA with gantry rotation and simulation with UG NX software. We also validated the consistency of rotational torque within the coronary artery lumen, irrespective of vessel twisting and deformation. The preliminary trial demonstrated a higher success rate (93.3% vs. 60%, p < 0.01) after training. Conclusion: Our novel method significantly improved the accuracy of guidewire manipulation in an in vitro model. This method therefore has the potential to enhance PCI outcome, and warrants further examination by clinical trials. 1 | Introduction The increasing age of the population and survival rates of patients with chronic diseases will lead to a greater incidence of complex coronary artery disease (CAD), and this will create a significant burden for interventional cardiologists [1] . In contrast to open‐heart surgery, percutaneous coronary intervention (PCI) requires the interventional cardiologist to operate using two‐dimensional X‐ray images on a screen. This leads to three major problems. First, an image on a two‐dimensional screen | Abbreviations: 3D, three‐dimensional; CAD, coronary artery disease; CAG, coronary angiography; CAU, caudal; CRA, cranial; CTO, chronic total occlusion; DSA, digital subtraction angiography; EBU, extra‐backup (guide catheter); GC, guide catheter; LAD, left anterior descending artery; LAO, left anterior oblique; OCT, optical coherence tomography; PCI, percutaneous coronary intervention; RAO, right anterior oblique; SAL, spatial left (guide catheter); UG NX, Siemens NX CAD/CAM software. | | --- | | This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial Li

FAQs

What problem does the study address in percutaneous coronary intervention (PCI)?

PCI traditionally relies on two-dimensional X-ray imaging, which provides limited depth perception and makes it harder to determine true/false lumen relationships and the direction of guidewire rotational torque.

How is stereoscopic perception established during coronary angiography (CAG)?

The approach uses digital subtraction angiography (DSA) with gantry rotation combined with UG NX simulation to determine guidewire tip orientation and the relative positions of the true lumen and false lumen.

What evidence supports the effectiveness of the new guidewire manipulation method?

Results showed accurate determination of guidewire tip orientation and true/false lumen positions, consistent rotational torque behavior within the coronary lumen, and a higher success rate after training in a 3D-printed heart model trial (93.3% vs. 60%, p < 0.01).

Sep 29, 2026

Uploaded by Emma Wilson