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

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.

How to Approach Below-the-Ankle Arterial Interventions

“…Smaller coronary support catheter use (i.e., Corsair, Asahi) followed by stiffer guidewire exchange may provide the needed support allowing more force to push the balloon. PIERCE or even direct extravascular calcium interruption arterial procedure (DECIAP) techniques have been described, 8 9 which involve externally trying to break the calcium by needle punctures into the area. The authors of this article have reservations about this approach as evidence is lacking and the potential for creating additional ulcerations is a possibility.…”