Rinato/PROWATER: Full-Length Hydrophilic Frontline Coronary Guidewire

Rinato/PROWATER® is a 0.014-inch full-length hydrophilic coronary guidewire from Asahi Intecc, distinguished from the SION family by its hydrophilic coating that extends along the entire wire length rather than a limited distal zone. This full-length coating minimises friction not only at the tip and lesion crossing zone but also throughout the wire’s passage through the guide catheter and the proximal coronary segment, resulting in a lower overall procedural friction profile than partially coated wires.

PROWATER was one of the first Asahi Intecc coronary wires to gain widespread international acceptance and served as the platform from which the current SION family was developed. It remains clinically relevant as a frontline workhorse for operators who prefer a full-length hydrophilic coating — particularly in tortuous, diffusely diseased, or heavily calcified vessels where friction reduction across the entire wire length is more important than the tip-load optimisation provided by the SION family.

Available in 180 cm straight configuration, PROWATER provides straightforward inventory management for centres that maintain a focused wire formulary. Its 0.014-inch outer diameter ensures compatibility with all standard coronary rapid-exchange and over-the-wire systems.

Outer diameter: 0.014 inch throughout. Coating: full-length hydrophilic (entire wire surface, from proximal shaft to tip). Available length: 180 cm (standard). Tip shape: straight. The full-length hydrophilic coating requires consistent saline wetting during the procedure; if the wire is allowed to dry partially, the hydrophilic layer loses its lubricity, potentially causing the wire to adhere to vessel walls or guide catheter inner surfaces.

The PROWATER shaft uses a standard stainless-steel core construction providing reliable pushability for the majority of coronary lesions. Tip load is in the standard frontline range, appropriate for non-CTO lesions. The full hydrophilic coat is the primary design feature, and all other specifications are subordinate to the goal of providing maximum-friction reduction across the entire wire-vessel interface.

PROWATER vs. SION: Standard SION uses the ACT ONE composite core with hydrophilic coating limited to the distal 28 cm. This provides superior torque transmission and tactile feedback in the proximal shaft, at the cost of more friction proximally. PROWATER’s full-length hydrophilic coating provides lower overall friction but reduces tactile feedback, making it better for cases where smooth tracking is prioritised over active steering.

PROWATER vs. PROWATERFLEX: PROWATERFLEX is the more flexible variant, with a softer shaft for distal vessel navigation. PROWATER is the stiffer, more pushable option — appropriate for straightforward tortuous vessels — while PROWATERFLEX is preferred for very distal or small-calibre branches where the shaft of standard PROWATER provides too much rigidity and risks vessel injury.

PROWATER vs. Terumo Runthrough NS: Both are hydrophilic-coated frontline wires with similar tip loads. Runthrough NS uses a full-length hydrophilic coat as well, making them functionally comparable. Institutional preference and pricing typically determine wire selection between these two for centres that use full-length hydrophilic wires as their primary frontline option.

PROWATER is most useful in tortuous coronary anatomy where friction accumulation along the entire wire length during device delivery is the limiting factor. In vessels with multiple sequential bends from the ostium to the lesion, the full-length hydrophilic coat reduces the cumulative friction from all bend contact points simultaneously, whereas a partially coated wire like SION leaves the proximal bends as friction sources.

Diffusely diseased vessels — particularly in diabetic patients with long segments of irregular intimal surface — benefit from PROWATER’s full-length coat, as the irregular intimal surface creates distributed friction rather than localised resistance. The hydrophilic coat normalises this distributed friction profile.

As a wire exchange tool, PROWATER’s full-length hydrophilic coat allows smooth exchange of microcatheters and over-the-wire balloons along the entire wire length simultaneously, which is particularly useful during complex multi-device exchanges in long procedures.

Keep the wire wet at all times: PROWATER’s full-length hydrophilic coat requires continuous saline exposure to maintain lubricity. Before inserting the wire into the guide catheter, wipe the wire with a saline-soaked gauze. Periodically flush the guide catheter with saline during the procedure to maintain moisture at the proximal wire segment within the catheter.

Because the entire wire surface is hydrophilic, PROWATER can be slippery to handle outside the patient. Use a wet gauze grip rather than dry fingers when manipulating the wire at the Y-connector. Avoid excessive rotation of PROWATER in tortuous vessels, as the full-length hydrophilic coat can reduce the tactile response to torque wind-up — withdraw the wire partially and counterrotate if multiple rotation cycles have been applied in one direction.

For lesion crossing, tip shaping is performed manually as with all standard wires. Given PROWATER’s full-length hydrophilic coat, a gentle 30–45° primary bend 1–2 mm from the tip is recommended for most anatomy. Avoid very sharp bends at the tip that could damage the hydrophilic coating at the tip flex zone.

Modern Medical Solutions supplies Rinato/PROWATER® in 180 cm straight configuration to interventional cardiology centres in Tajikistan and Afghanistan as the authorised Asahi Intecc distributor. PROWATER is available as part of the standard frontline wire formulary alongside the SION family and PROWATERFLEX.

For centres reviewing their frontline wire selection — particularly those managing high volumes of tortuous or diffusely diseased cases — Modern Medical Solutions clinical specialists can advise on the relative merits of PROWATER versus SION family wires for specific patient populations. Contact the team via the Modern Medical Solutions website.