Novel approach in neurovascular navigation: Artiria Medical SmartGUIDE deflectable tip microwire.

Neurointerventionalists increasingly treat distal vascular targets with complex anatomy. Current guidewires require iterative hand shaping of the tip to navigate microcatheters and devices. Manual shaping often necessitates wire removal and reinsertion, risking wire damage, longer procedural times, increased vessel injury, and higher costs. The Artiria Medical SmartGUIDE 1 enables real time in situ tip deflection, allowing a single wire to reach a wide range of targets without manual reshaping. It can be locked in position to anchor microcatheters at branch points and prevent buckling or herniation, obviating the need for ancillary support devices, such as a balloon or metallic mesh. The wire can also shape and steer microcatheters on demand by torquing from within, potentially reducing risky maneuvers, such as looping within an aneurysm dome. We demonstrate the use of the deflectable Artiria Medical SmartGUIDE microwire in navigating through tortuous ophthalmic artery branches to perform preoperative embolization of highly vascular orbital tumor (video 1). We provide a comprehensive up to date comparison to other real-time steerable devices.2 3 4 5 6 7neurintsurg;jnis-2025-023947v1/V1F1V1Video 1-Artiria Medical SmartGUIDE 0.014'' Deflectable-Tip Microwire.