Cutting Balloon Before Stent: Angiographic and IVUS Correlation

A 50-year-old male presented with de novo rest angina. The panel at the left demonstrates the angiographic and intravascular ultrasound (IVUS) appearance of the lesion pre-treatment. Following Cutting Balloon angioplasty with a 4.0 mm device, the center panel demonstrates the IVUS appearance showing remnants of the atherotome incisions, best seen at the 2 o’clock, 5 o’clock and 7 o’clock positions. The panel to the right demonstrates the final lesion appearance after implantation of a 5.0 NIR stent, requiring only 10 atmospheres to achieve full stent deployment. Lesion microsurgical incision with a Cutting Balloon as a pre-treatment to stenting may facilitate improved stent-to-wall apposition and symmetry at relatively low deployment pressures.

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