A cutting balloon is a medical instrument used in interventional cardiology procedures which are designed to treat atherosclerosis. In patients with atherosclerosis, a buildup of plaque on the insides of the arteries has causes stenosis, or narrowing, which leads to a variety of cardiovascular problems. Interventional cardiologists go into the blood vessels to remove the plaque, and may also insert a stent, which expands to hold the vessel open so that blood can continue to flow.
In the case of the cutting balloon, the device is equipped with a small inflatable balloon and a head with small blades on the tip. The cutting balloon is guided into the artery being treated, usually with the assistance of medical imaging to ensure that it is placed properly, and the tips are used to score the plaque on the walls of the artery. This can help to remove some of the plaque, and it also reduces tension in the vessel. The plaque is carried away in the bloodstream and expressed as a waste product.
When the balloon is inflated, it pushes the plaque back against the walls of the artery, widening it. The scores created by the small blades help the plaque to crack and score without stressing the artery. This means that less pressure is needed to inflate the balloon, which can contribute to a reduction in the risk of injury to the blood vessel. Once the balloon has expanded the vessel, a stent which may be coated in medication to reduce plaque buildup can be placed to hold it open.
Using a cutting balloon for stenting appears to reduce the risk of restenosis, in which the plaque reforms around and over the stent. This means that the patient will be less likely to need another procedure, and will enjoy better health. In addition, cutting balloons can be very effective in the treatment of restenosis if an older stent is being overgrown with plaque.
This device has been used in atherectomy or plaque removal procedures since the 1990s. Versions are manufactured by several companies which produce scientific tools and medical instruments. Cutting balloons are usually designed as single use instruments which are employed in a single patient and then discarded. As such, they are not designed in a way which would facilitate sterilization, which would make it difficult and dangerous to reuse the cutting balloon device in another person.