Cutting Balloon Angioplasty in the Treatment of Short Infrapopliteal Bifurcation Disease.

Roberto Iezzi, Alessandro Posa, Marco Santoro, Massimiliano Nestola, Andrea Contegiacomo, Giovanni Tinelli, Alessandra Paolini, Andrea Flex, Dario Pitocco, Francesco Snider, Lorenzo Bonomo

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4 Citations (Scopus)


PURPOSE: To evaluate the safety, feasibility, and effectiveness of cutting balloon angioplasty in the management of infrapopliteal bifurcation disease. METHODS: Between November 2010 and March 2013, 23 patients (mean age 69.6±9.01 years, range 56-89; 16 men) suffering from critical limb ischemia were treated using cutting balloon angioplasty (single cutting balloon, T-shaped double cutting balloon, or double kissing cutting balloon technique) for 47 infrapopliteal artery bifurcation lesions (16 popliteal bifurcation and 9 tibioperoneal bifurcation) in 25 limbs. Follow-up consisted of clinical examination and duplex ultrasonography at 1 month and every 3 months thereafter. RESULTS: All treatments were technically successful. No 30-day death or adverse events needing treatment were registered. No flow-limiting dissection was observed, so no stent implantation was necessary. The mean postprocedure minimum lumen diameter and acute gain were 0.28±0.04 and 0.20±0.06 cm, respectively, with a residual stenosis of 0.04±0.02 cm. Primary and secondary patency rates were estimated as 89.3% and 93.5% at 6 months and 77.7% and 88.8% at 12 months, respectively; 1-year primary and secondary patency rates of the treated bifurcation were 74.2% and 87.0%, respectively. The survival rate estimated by Kaplan-Meier analysis was 82.5% at 1 year. CONCLUSION: Cutting balloon angioplasty seems to be a safe and effective tool in the routine treatment of short/ostial infrapopliteal bifurcation lesions, avoiding procedure-related complications, overcoming the limitations of conventional angioplasty, and improving the outcome of catheter-based therapy.
Original languageEnglish
Pages (from-to)485-492
Number of pages8
JournalJournal of Endovascular Therapy
Publication statusPublished - 2015


  • angiosome
  • balloon angioplasty
  • bifurcation
  • critical limb ischemia
  • infrapopliteal arteries
  • revascularization


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