ABSTRACT
This chapter analyzes appropriate atherosclerotic plaque modification before coronary stent implantation using cutting and scoring balloons. Plaque modification prior to stent implantation using cutting and scoring balloons is an essential tool to achieve the best possible result and ensure the long-term safety and efficacy of percutaneous coronary intervention (PCI). Stent expansion remains an important predictor of restenosis and subacute thrombosis, even in the drug-eluting stent (DES) era. Plaque modification with rotational atherectomy or predilatation with a cutting balloon (CB) has been demonstrated to improve stent expansion. The chapter also analyzes some clinical cases using cutting and scoring balloons in plaque pretreatment and optical coherence tomography (OCT) guidance for optimal stent deployment. OCT imaging was performed after intracoronary injection of nitroglycerin before and after CB pretreatment, and after stent implantation. The chapter suggests that use of appropriate plaque modification and IVUS guidance during intervention significantly increases the acute and postprocedural results of angioplasty.
