Management of resistant coronary lesions by the cutting balloon catheter: Initial experience

Pci in Patient With Heavy Calcified Lesion. Management and Balloon Rupture Complication

“…One of the causes of coronary lesions resistance (lesions that are difficult to be dilated) is calcified lesions. Resistant coronary lesions itself is a challenge in the world of modern angioplasty (Teirstein et al 2007, Bertrand et al 1997. The process with which balloon can cross the lesion and carrying out predilatation and ended with stenting provides a challenge to the skills and experience of the operators who handle heavy calcified lesions, since the lesion is accompanied by highly angulated lumen and resistance to dilation (Bonzel et al 2012).…”

“…Another way to hugging balloon technique is to inflate two balloons at a time with two wires on the lesion with critical stenosis, using the pressure of 12 atm respectively. Based on research Kanh et al, most lesions can be dilated with pressure below 10 atm (Bertrand et al 1997). In lesions that potentially could be dilated, the choice of balloon used: non-compliant balloon, balloon and fx minirail cutting balloon (Teirstein et al 2007).…”

“…This tool is not recommended for use on turtous lesions, eccentric lesions, calcified lesions partially because the risk of arterial dissection and perforation which microblade can injure healthy blood vessel walls. Cutting balloon can also be used in predilatation before stenting (Teirstein et al 2007, Cleman 1992, Bertrand et al 1997, Bonzel et al 2012.…”

“…The new most technique leffective is rotational atherectomy. Nevertheless, in some cases the use of the new technology still requires additional balloon angioplasty (Bertrand et al 1997, Pedersen et al 2003. This technique is done if it is found lesions in the distal segment, while the proximal segment shows heavy calcification and tortuous (angulation of> 60 degrees), where the cutting balloon difficult to achieve (Nguyen et al 2003) as well as in the event of a failure to act balloon angioplasty (Teirstein et al 2007).…”

“…Adjuvant PTCA (using non-compliant balloon) or stenting action often produces lumen enlargement without dissection (Bertrand et al 1997). Stenting or simply PTCA alone after rotablation or not depends on the location of calcified lesion in or superficial and depends on the size of the lumen of a coronary artery intervention (Freed & Safian 2011).…”