The direct extravascular calcium interruption arterial procedure technique for heavily calcified vessels

Steven Kum; Eline Huizing; Lasitha Bhagya Samarakoon; Darryl Lim; Çağdaş Ünlü; Tomoyasu Sato

doi:10.1016/j.jvscit.2020.04.007

The direct extravascular calcium interruption arterial procedure technique for heavily calcified vessels

J Vasc Surg Cases Innov Tech. 2020 May 11;6(3):369-373. doi: 10.1016/j.jvscit.2020.04.007. eCollection 2020 Sep.

Authors

Steven Kum¹, Eline Huizing², Lasitha Bhagya Samarakoon³, Darryl Lim¹, Çağdaş Ünlü², Tomoyasu Sato⁴

Affiliations

¹ Vascular Service, Department of Surgery, Changi General Hospital, Singapore.
² Department of Surgery, Northwest Clinics, Alkmaar, The Netherlands.
³ Department of General Surgery, Changi General Hospital, Singapore.
⁴ Department of Interventional and Diagnostic Radiology, Tsuchiya General Hospital, Hiroshima, Japan.

Abstract

Severely calcified lesions continue to plague endovascular interventions by negatively affecting the acute and long-term results. A new technique was developed to allow balloon crossing or to treat persistent recoil. In the direct extravascular calcium interruption arterial procedure technique, an artery forceps is percutaneously introduced to modify the plaque after conventional techniques have failed. In this initial experience, the direct extravascular calcium interruption arterial procedure technique was successful as a bailout option in patients in whom balloon crossing was impossible or recoil was untreatable even with high-pressure balloons.

Keywords: Calcification; Critical limb-threatening ischemia; Infrainguinal; Infrapopliteal; Lesions; Percutaneous transluminal angioplasty; Peripheral arterial disease; Recoil; Technique.