External calcium modification technique to overcome a balloon uncrossable chronic total occlusion: a report of two cases and review of the literature
Hashalemi, Arash; Karagoz, Ahmet; Bayani, Baktash; Turhan Calar, Nihan; Zoghi, Mehdi; Ucar, Melisa
ABSTRACT
Introduction: chronic total occlusion is the most challenging part of percutaneous coronary intervention. In balloon uncrossable lesions, the wire can be advanced throughout the lesion to the distal part of the vessel, while the balloon can not.
Case report: in this scenario, there are very few options to perform. Herein, we present two cases of balloon uncrossable chronic total occlusion, in which all the other methods were unsuccessful.
Conclusion: we called this technique "external calcium modification" in which a balloon uncrossable lesion was overcome by cracking the calcified plaque via balloon inflation in the subintimal area over an intentionally directed wire around the calcium in subintimal space.
