title: Utility of a scoring balloon for a severely calcified lesion: bench test and finite element analysis.
abstract: We aimed to investigate the effectiveness of a scoring balloon catheter in expanding a circumferentially calcified lesion compared to a conventional balloon catheter using an in vitro experiment setting and elucidate the underlying mechanisms of this ability using a finite element analysis. True efficacy of the scoring device and the underlying mechanisms for heavily calcified coronary lesions are unclear. We employed a Scoreflex scoring balloon catheter (OrbusNeich, Hong Kong, China). The ability of Scoreflex to dilate a calcified lesion was compared with a conventional balloon catheter using 3 different sized calcium tubes. The thickness of the calcium tubes were 2.0, 2.25, and 2.5 mm. The primary endpoints were the successful induction of cracks in the calcium tubes and the inflation pressures required for inducing cracks. The inflation pressure required for cracking the calcium tubes were consistently lower with Scoreflex (p < 0.05, Student t test). The finite element analysis revealed that the first principal stress applied to the calcified plaque was higher by at least threefold when applying the balloon catheter with scoring elements. A scoring balloon catheter can expand a calcified lesion with lower pressure than that of a conventional balloon. The finite element analysis revealed that the concentration of the stress observed in the outside of the calcified plaque just opposite to the scoring element is the underlying mechanism of the increased ability of Scoreflex to dilate the calcified lesion.
authors: Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan.
authors: Yoshiaki
authors: Y
authors: Kawase
authors: Naritatsu
authors: N
authors: Saito
authors: Shin
authors: S
authors: Watanabe
authors: Bingyuan
authors: B
authors: Bao
authors: Erika
authors: E
authors: Yamamoto
authors: Hiroki
authors: H
authors: Watanabe
authors: Hirooki
authors: H
authors: Higami
authors: Hitoshi
authors: H
authors: Matsuo
authors: Katsumi
authors: K
authors: Ueno
authors: Takeshi
authors: T
authors: Kimura
mesh_terms: D000800:Angioplasty, Balloon; D002114:Calcinosis; D057785:Catheters; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000628:therapy; D004867:Equipment Design; D020342:Finite Element Analysis; D006801:Humans; D058226:Plaque, Atherosclerotic / Q000473:pathology*; D015203:Reproducibility of Results; D012720:Severity of Illness Index