AngioSculpt® scoring balloon catheter: an atherotomy device for coronary and peripheral interventions

During the past three decades, the landscape of percutaneous cardiovascular interventions (PCIs) has dramatically changed. Improved technical experience coupled with a vast array of technologies to choose from has allowed the interventional cardiologist to tackle increasingly complex anatomy for revascularization. While stent implantation is undoubtedly the mainstay of the current percutaneous approach in the coronary vasculature, certain types of lesions remain a challenge for optimizing vessel patency, even in the modern stent era. There is significant heterogeneity in practice and controversy regarding the best approach to complex lesions involving the coronary ostia, vessel bifurcations, heavily calcified vessels, and chronic total occlusions. Even when stent implantation is planned, there are many potential strategies for lesion preparation, including direct stenting, balloon predilation, atheroablation (i.e., rotablator or excimer laser) and atherotomy or scoring systems (i.e., cutting and scoring balloons).