Conclusion
A dedicated RF wire had greater success and consistency in achieving TSP compared to electrified metal guidewires, which required higher power, were more dependent on the distance between the wire tip and dilator tip, and required more RF applications to perforate tissues. Use of electrified guidewires for TSP was associated with damage to the guidewire and dilator and may present electrosurgical hazards, as well as risks of thrombus, thermal injury, and tissue scarring. Further studies are needed to identify the clinical implications of these findings and assess cost considerations related to routine use of dedicated RF wires for TSP.