A percutaneous intravascular cracking (PICKING) with a TruePath™ for extremely calcified lesions
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A PICKING technique: percutaneous intravascular cracking with a guidewire tail, which indicated longitudinal repeated cracking of the calcified lesion by a stiff tail of a guidewire with the parallel-wire method under fluoroscopy guidance, was previously reported to make balloon catheter delivery easier for severely calcified lesions [1, 2]. However, this technique might have some problems as follows: (1) a potential risk of vessel perforation mainly because of the poor fluoroscopic visibility of the guidewire tail; and (2) poor handling of its direction, etc.
We would like to express our gratitude to Mr. John Martin for his grammatical assistance.
Compliance with ethical standards
Conflict of interest
The authors have no conflicts of interest to declare.
Video clip 1. Failure to cross the calcification with CROSSER™. The CROSSER™ could not cross the calcification, which made us to decide using The PICKING technique with a TruePath™. (MP4 6482 kb)
- 3.Ichihashi S, Sato T, Iwakoshi S, Hirofumi I, Kimihiko K. 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. J Vasc Interv Radiol. 2014;25:784–8.CrossRefPubMedGoogle Scholar