A guidewire manipulation device includes a housing configured to be supported by the hand of a user, the housing having a distal end and a proximal end, the housing configured to allow a guidewire to be placed therethrough and extend between the distal end and proximal end, a drive system carried by the housing and configured to drive rotation of the guidewire, and a manual input module carried by the housing, the manual input module configured to allow one or more fingers of the hand of the user to manually stop or slow the rotation of the guidewire while the housing is supported by the hand of the user.
