Currently, the success rate of EVT for treating CTO of the SFA is high; however, EVT is still found to be insufficient in treating CTOs with severely calcified lesions. Even if the guidewire crosses the lesion, the calcifications may still cause difficulties during stent expansion. A 78-year-old male had been reported to have intermittent claudication with chronic total occlusion (CTO) of the right superficial femoral artery (SFA). Angiography revealed severely calcified plaque (Angiographic calcium score: Group4a [1]) at the ostium of the SFA. Stenting posed a risk of underexpansion, causing the plaque to shift to the deep femoral artery. we decided to remove the calcified plaque using biopsy forceps. After removing the extended calcified plaque, the guidewire could cross easily, and the self-expandable stent was well dilated without causing the plaque to shift to the DFA. Biopsy forceps may be used in some endovascular cases to remove severely calcified lesions. To ensure the safety of the patient, the physician must be adept at performing this technique before attempting it.

中文翻译：

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心肌活检钳对股浅动脉严重钙化斑块的血管内治疗

目前EVT治疗SFA CTO的成功率较高；然而，仍然发现EVT不足以治疗严重钙化病变的CTO。即使导丝穿过病灶，钙化仍可能在支架扩张过程中造成困难。据报道，一名 78 岁男性出现间歇性跛行伴右股浅动脉 (SFA) 慢性完全闭塞 (CTO)。血管造影显示 SFA 开口处严重钙化斑块（血管造影钙评分：Group4a [1]）。支架植入存在扩张不足的风险，导致斑块转移到股深动脉。我们决定使用活检钳去除钙化斑块。去除扩展的钙化斑块后，导丝很容易穿过，并且自扩张支架扩张良好，没有导致斑块转移到DFA。在一些血管内病例中，活检钳可用于去除严重钙化的病变。为确保患者的安全，医生在尝试之前必须熟练执行此技术。