Evaluation of the Clinical Efficacy of Cutting Balloons in Treating Calcified Coronary Artery Lesions: Enhancing Procedural Success and Patient Outcomes in Severe Calcification

Abstract Coronary re-stenosis, marked by the narrowing of coronary arteries due to plaque accumulation, often leads to symptoms such as chest pain and potentially life-threatening conditions like heart attacks. Conventional treatments for coronary re-stenosis encompass several methods. Angioplasty (Percutaneous Coronary Intervention - PCI) involves using a balloon-tipped catheter to compress plaque against artery walls, thereby widening the artery. While effective, its success is limited in heavily calcified lesions. Stenting, typically performed alongside angioplasty, employs a wire mesh tube to keep the artery open post-balloon removal. Although, calcified plaques can impede stent expansion and placement. However, atherectomy, which mechanically removes plaque using a cutting balloon consisted of microsurgical blades, proves beneficial for calcified lesions. Medications, including antiplatelet agents, statins, beta-blockers, and ACE inhibitors, are employed to manage symptoms and prevent further plaque buildup. This study evaluates the clinical effectiveness of cutting balloons, a novel intervention designed for highly calcified and stiff coronary artery lesions. Cutting balloons, equipped with small blades, make controlled incisions in the plaque during inflation, promoting more effective artery dilation. This approach reduces the necessary pressure for artery expansion and improves procedural outcomes, particularly in calcified lesions where conventional angioplasty might be inadequate. Our findings indicate that cutting balloons enhance procedural success, lower the risk of arterial dissection, and improve stent placement. This research underscores the advantages of cutting balloons in treating challenging cases, highlighting their potential to improve patient outcomes in the presence of severe calcification and positioning them as a promising alternative to traditional methods.