Use of cutting or scoring balloons in patients with native coronary artery disease: systematic review and meta-analysis

Abstract

To the Editor, Calcified coronary lesions remain a procedural and clinical challenge associated with higher rates of procedural complications such as stent underexpansion and malapposition leading to an increased risk of target lesion revascularization (TLR), stent thrombosis, myocardial infarction (MI), and death.1 While newer drug-eluting stents and advanced devices are considered safer and more effective, there is still a need for atherosclerotic plaque modification techniques that allow for adequate stent expansion and apposition when traditional techniques fail. Cutting and scoring balloons have been designed to treat complex lesions such as fibrotic plaque and calcified lesions.2,3 However, their use may have been limited by problems of crossability and limited evidence supporting their efficacy and safety.4 In addition, the available published literature is based on studies with noninferiority designs and small sample sizes,5 which may not provide adequately powered analyses to evaluate the clinical efficacy of cutting and scoring balloons in patients with native-vessel coronary artery disease (CAD). Therefore, we performed a systematic review and meta-analysis to compare cutting and scoring balloons with conventional balloons (semi- and non-compliant balloons) in patients with native vessel CAD. This meta-analysis was conducted according to the PRISMA guidelines for the reporting of systematic reviews. Two reviewers independently identified...