A Case of Picking Calcified Plaque In The Common Femoral Artery With A Long Needle: The “Calc-Pick Technique”

Abstract

An 88-year-old male had intermittent claudication of his right leg. Angiography revealed severely calcified plaque in the common femoral artery. Endovascular treatment was performed by contralateral approach. We attempted to penetrate the center of the calcified plaque and perform balloon dilatation. However, a 0.014-inch stiff guidewire could not enter center of the lesion. Thus, we used a inner cylinder of 15-cm 20G long needle directly through the retrograde femoral sheath and successfully introduce the guidewire into the calcified plaque. Crosser and balloon dilatation resulted 50% stenosis. To cross the center of calcified plaque is important to get sufficient lumen gain at the nonstenting zone.