The most common mode of failure for percutaneous vascular interventions (PVI) is the inability to cross hard lesions with a guidewire. This study uses magnetic resonance (MR) lesion characterization to predict the difficulty of PVI. Steady state free precession (SSFP) MR angiography and ultrashort echo time imaging were used to categorize lesions as “hard” (e.g. calcium, collagen), or “soft” (thrombus, lipids). 17 patients were imaged prior to PVI. MRI-defined hard lesions required significantly longer time to cross (14.81 min vs 1.61 min) and required stenting more often.