EMRAH ACAR İBRAHİM DÖNMEZ SERVET İZCİ TUBA KAYGUSUZ EDA ÖZCAN İSA SİNCER İBRAHİM AKIN İZGİ YILMAZ GÜNEŞ
Northwestern Medical Journal - 2025;5(2):122-126
It may be difficult to pass the device through the lesion due to moderate or severe calcification, tortuosity in or proximal to the lesion, excessive plaque load, the age of the lesion, and the characteristics of the device to be used. In such cases, the first thing that comes to mind is maneuvers to increase the support of the system. It may be preferable to choose low-profile and more flexible devices, or to angioplasty with small balloons and try again with a larger one. Intravascular ultrasound (IVUS) guidance and plaque debulking devices such as special balloons or atherectomy/laser/lithotripsy can be used to prepare the lesion. In addition, special lesion crossing devices can be used. However, the tools and equipment required for the special methods listed above are not available in every catheterization laboratory or they are not widely used because their use is not widely recommended and because of payment issues. We encountered a lesion that could not be passed through such a device, and we modified the plaque by injecting contrast directly into the lesion, as in the Carlino method.
