title: Cutting balloons for the treatment of vascular stenoses.
abstract: The aim of this article is to review the mechanism, technical characteristics, biological response and clinical applications of cutting balloon angioplasty in peripheral vessels. The cutting balloon is a non-compliant, balloon catheter equipped with three-to-four microtome-sharp atherotomes. When used appropriately, it is safe and easy to use, with a high immediate success rate and few complications, provided oversizing is avoided. There is some evidence that pre-dilation with a standard or high-pressure balloon may also predispose to vascular rupture. The cutting balloon has proved to be beneficial in treating difficult complex lesions in the coronary arteries. Early experience in non-coronary vessels shows that cutting balloon angioplasty can be used to treat peripheral bypass anastomotic and haemodialysis fistula stenoses that are resistant to conventional high-inflation pressures. Its application in de novo peripheral arterial lesions and non-coronary in-stent restenosis is still under discussion. Theoretically, this device induces a smaller degree of vessel wall injury localised to the area of incisions and sparing the interincisional segments; however, this postulated reduction in restenosis rates has not been confirmed in clinical practice.
authors.affiliation: Department of Radiology, Medical School of Crete, University Hospital of Heraklion, Heraklion, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tsetis
authors.forename: Robert
authors.initials: R
authors.lastname: Morgan
authors.forename: Anna-Maria
authors.initials: AM
authors.lastname: Belli
mesh_terms: D000792:Angiography; D000800:Angioplasty, Balloon / Q000295:instrumentation*; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D006083:Graft Occlusion, Vascular / Q000628:therapy*; D006801:Humans; D016491:Peripheral Vascular Diseases / Q000628:therapy*; D014654:Vascular Patency