Kissing-Balloon Angioplasty With a New Low-Profile Catheter for the Popliteal Trifurcation

Cutting Balloon Angioplasty in the Treatment of Short Infrapopliteal Bifurcation Disease

“…In particular, the treatment of bifurcation lesions with a single balloon dilation increases the risk of plaque shift to the side branch and recurrent stenosis involving the main vessels or, more commonly, the side branch of bifurcated lesions. 4,5,17 It is well known that maximizing blood flow to the foot by revascularizing more than one tibial artery speeds wound healing and increases limb salvage rates. 18–20 On the other hand, choosing which artery to preserve can be difficult, especially when a dominant vessel cannot be recognized, and both vessels are patent to the distal foot.…”

“…2,3 Several aggressive techniques have been developed to improve patency of PTA in vessels below the knee; the "kissing dilation technique," for example, is often used to avoid recurrent problems of plaque shifting observed when the two branches are dilated separately. 4,5 Percutaneous transluminal angioplasty achieves a technically successful result (<30% residual stenosis) in most cases, but it is limited by high restenosis rates owing to elastic recoil or flow-limiting dissection requiring stent implantation or, when dealing with late restenosis, to vascular inflammatory reactions in terms of negative remodeling or neointima formation. 6 In the last few years, a new system of balloon angioplasty has emerged; based on a controlled and less traumatic dilation of the lesion, cutting balloon angioplasty (CBA) has the potential to improve the outcome of catheter-based therapy by minimizing elastic recoil and achieving better angiographic results.…”

“…2,3 Several aggressive techniques have been developed to improve patency of PTA in vessels below the knee; the “kissing dilation technique,” for example, is often used to avoid recurrent problems of plaque shifting observed when the two branches are dilated separately. 4,5…”