title: Technique of percutaneous direct needle puncture of calcified plaque in the superficial femoral artery or tibial artery to facilitate balloon catheter passage and balloon dilation of calcified lesions.
abstract: Heavy calcified arterial lesions are challenging to endovascular treatment. Even if a guide wire passes the lesion, calcified plaque can inhibit passage or dilation of the balloon catheter. We developed a novel technique of percutaneous direct needle puncture of calcified plaque (PIERCE) to allow subsequent passage and dilation of the balloon. PIERCE was performed in three patients with superficial femoral artery (SFA) lesions and one patient with a tibial artery lesion. In all four cases, balloon passage and lesion dilatation were achieved. Minor hemorrhage from the punctured site occurred in two patients with SFA lesions, which resolved with stent placement.
authors.affiliation: Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521. Electronic address: shigeoichihashi@yahoo.co.jp.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Ichihashi
authors.affiliation: Department of Radiology, Tsuchiya General Hospital, Hiroshima, Japan.
authors.forename: Tomoyasu
authors.initials: T
authors.lastname: Sato
authors.affiliation: Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Iwakoshi
authors.affiliation: Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Itoh
authors.affiliation: Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521.
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Kichikawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000628:therapy*; D002406:Catheterization, Peripheral / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D011677:Punctures / Q000295:instrumentation / Q000379:methods*; D015641:Radiography, Interventional / Q000379:methods; D016909:Tibial Arteries / Q000000981:diagnostic imaging*; D016896:Treatment Outcome