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Related Experiment Video

Updated: Jan 10, 2026

Balloon-based Injury to Induce Myointimal Hyperplasia in the Mouse Abdominal Aorta

Balloon-based Injury to Induce Myointimal Hyperplasia in the Mouse Abdominal Aorta

Published on: February 7, 2018

Balloon Uncrossable Lesions.

Nodari Maisuradze¹, Nikoloz Koshkelashvili², Daniel Gold¹

¹Division of Cardiology, Department of Internal Medicine, Emory University School of Medicine, 1364 Clifton Road, Atlanta, GA 30322, USA.

Interventional Cardiology Clinics

|November 23, 2025

Summary

This summary is machine-generated.

Managing balloon-uncrossable chronic total occlusion (CTO) lesions requires a structured approach. Escalating techniques, from support optimization to plaque modification and subintimal methods, improve procedural success and minimize complications.

Keywords:

Chronic total occlusion (CTO)Coronary revascularization Percutaneous coronary interventions (PCI)Uncrossable lesions

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Area of Science:

Interventional Cardiology
Vascular Medicine

Background:

Balloon-uncrossable chronic total occlusion (CTO) lesions are a significant challenge in percutaneous coronary intervention, often leading to procedural failure.
These complex lesions are associated with increased contrast use, radiation exposure, and adverse clinical outcomes.

Purpose of the Study:

To outline a structured escalation strategy for the effective management of balloon-uncrossable CTO lesions.
To guide interventional cardiologists in optimizing procedural success and minimizing complications in complex CTO cases.

Main Methods:

The strategy involves a stepwise escalation of techniques, starting with support optimization (e.g., large-bore guides, guide extensions).
Subsequent steps include using advanced microcatheters, specialized balloons, plaque modification devices (laser, atherectomy), and finally, subintimal techniques (e.g., external crush).

Main Results:

A structured escalation pathway allows operators to systematically address challenging CTO lesions.
This approach aims to maximize procedural success rates for balloon-uncrossable CTOs.
Minimizing complications such as contrast use and radiation exposure is a key benefit.

Conclusions:

Implementing a structured escalation strategy is crucial for managing balloon-uncrossable CTO lesions effectively.
This systematic approach enhances procedural success and patient outcomes while reducing risks.
The described pathway provides a framework for tackling complex CTOs in interventional cardiology.