Evaluation of the Crossing Forces of a Vibrating Guidewire in Contact with Model Calcified Materials

Peripheral arterial disease (PAD) affects millions globally, with over 21 million cases reported in the U.S. in 2020. It occurs when leg arteries become narrowed or blocked, leading to complications like critical limb ischemia, where blood flow is severely restricted. Standard treatments, such as bypass surgery and endovascular procedures, aim to restore blood flow. However, advanced chronic total occlusions with calcified plaques, often prevent flexible guidewires crossing into the true lumen of the distal vessel, accounting for approximately 80% of procedural failure. The use of high-frequency (20- 50 kHz) mechanical vibrations (0-50 μm) delivered to the distal tip of specialist guidewires has been shown to ablate calcified plaques, as shown in Figure 1 .