If resistance is encountered while advancing a lead in an SCS trial, what might you suggest?

When encountering resistance while advancing a lead in an SCS trial, suggesting the use of a guidewire or altering the needle angle is a sound approach. This method allows for better navigation and control, which can help overcome any obstructions or anatomical challenges that may be causing the resistance.

Using a guidewire can provide a stable pathway for the lead, making it easier to maneuver through tissues and ensuring that the pathway remains open. Additionally, changing the angle of the needle can help in finding a more favorable trajectory through the difficult anatomy, reducing friction or obstruction that may be causing resistance.

Other options, such as using a larger needle or advancing with more force, could lead to increased trauma to the surrounding tissue or complications. Changing the procedure completely may not be necessary, as often, a slight adjustment in technique can resolve the issue without abandoning the current approach. Thus, utilizing a guidewire or modifying the needle angle is the most effective strategy for overcoming resistance in this context.