Clinical Experience of Cutting Balloon Angioplasty for in Stent Restenosis

ABSTRACT

BACKGROUND AND OBJECTIVES: A cutting balloon (CB) is a balloon catheter with 3 or 4 metal blades on its surface used for making controlled endovascular surgical incisions and promising minimal intimal injury. Some reports suggest advantages of the use of CB in the treatment of in-stent restenosis (ISR). The purpose of this study was to report the clinical experience of the use of CB for ISR. SUBJECTS AND METHODS: 28 patients were enrolled in this study. Angiographic success (defined by 40% residual stenosis), in-hospital, 30 days and 6 months clinical outcomes were evaluated. RESULTS: Angiographic success was 92.9% (26/28). The number of inflations and maximal inflation pressure were 2.8+/-0.9 and 10.1+/-1.3 ATM, respectively. The balloon/artery (B/A) ratio was 1.1+/-0.2. There was a case of stent insertion for treating type D dissection and a case of rotational atherectomy for suboptimal result after CB angioplasty. 25 cases underwent analysis through 6 months of clinical follow-up. During the 6-month clinical follow-up, 4 cases of re-PTCA were documented, while MACE during in-hospital time and the subsequent 30 days was 0%. CONCLUSION: Our experience demonstrated that CB can be performed safely and effectively in coronary ISR. Further clinical and angiographic effectiveness are warranted in a large-scale clinical trial.