Guidewire iron man

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

The Iron Man is a stiff coronary guidewire with poor steerability whose rigidness is used to straighten vessel segements and allow better transmission of forces pushing balloons or stents. This property comes from the tendency of the wire to retain its shape rather than conform to the contours of the vessel.

The straightening and stiffening of the wire can result in a “cheese cutter” effect on the vessel intima at the bends of coronary arteries. The wire can also cause a “pleating artifact” that mimics a lesion and can trigger the placement of an additional stent. In order to ascertain if a new lesion is truly a lesion, the wire should be pulled back to the distal end of the lesion or the stent to see if the pseudolesion disappears.

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