Abstract

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.

Keywords: angioplasty, contrast agent, device, lesion, peripheral

Copyright and license

Copyright © 2025 The Author(s). This is an open-access article published by Bolu İzzet Baysal Training and Research Hospital under the terms of the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Acar E, Dönmez İ, İzci S, Kaygusuz T, Özcan E, Sincer İ, et al. Direct contrast injection method: a novel approach to facilitate device crossing in peripheral artery lesions. Northwestern Med J. 2025;5(2):122-6. https://doi.org/10.54307/2025.NWMJ.94

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