Ungureanu Claudiu, Leibundgut Gregor, Cocoi Mihai, Gasparini Gabriele, Colletti Giuseppe, Avran Alexandre, Poletti Enrico, Moroni Alice, Mangieri Antonio, Dumitrascu Silviu, Mozid Abdul, Boukhris Marouane, Achim Alexandru, Zivelonghi Carlo, Bentakhou Elias, Agostoni Pierfrancesco
Department of Cardiology, Hôpital de Jolimont, La Louvrière, Belgium.
University Hospital Basel, Basel, Switzerland.
Catheter Cardiovasc Interv. 2025 Mar;105(4):805-812. doi: 10.1002/ccd.31387. Epub 2025 Jan 5.
Heavily calcified coronary artery disease presents significant challenges in percutaneous coronary intervention (PCI), often requiring advanced techniques to achieve optimal outcomes. Cutting balloons (CB) have shown potential for plaque modification; however, their effectiveness is limited without standardized protocols.
This study introduces the RODIN-CUT technique, a novel approach utilizing sequential CB inflations with real-time intravascular ultrasound (IVUS) guidance. The technique aims to enhance calcified plaque modification, improve stent expansion, and achieve consistent procedural success in heavily calcified coronary lesions.
A retrospective analysis of three consecutive patients requiring specialized approaches beyond conventional PCI was included at three centers in Belgium. The RODIN-CUT protocol involved multiple CB inflations at precise lesion segments, followed by immediate IVUS imaging after each inflation to assess plaque modification and guide further therapy. Procedural success was defined as residual stenosis < 30% with TIMI 3 distal flow. The study evaluated the dose-dependent effects of repeated CB inflations on plaque fracture depth and distribution.
The RODIN-CUT technique demonstrated promising outcomes, achieving procedural success in all cases with enhanced stent expansion and minimal complications. The technique's simplicity, cost-effectiveness, and reproducibility make it a viable option for treating heavily calcified coronary lesions. Further large-scale studies are required to validate these findings and establish the RODIN-CUT technique as a standard approach for complex calcified lesions.
严重钙化的冠状动脉疾病在经皮冠状动脉介入治疗（PCI）中面临重大挑战，通常需要先进技术才能实现最佳治疗效果。切割球囊（CB）已显示出对斑块进行改良的潜力；然而，在缺乏标准化方案的情况下，其有效性有限。
本研究介绍了RODIN-CUT技术，这是一种在血管内超声（IVUS）实时引导下利用连续CB充盈的新方法。该技术旨在增强钙化斑块改良效果，改善支架扩张，并在严重钙化的冠状动脉病变中实现持续的手术成功。
在比利时的三个中心对连续3例需要采用常规PCI以外的特殊方法的患者进行了回顾性分析。RODIN-CUT方案包括在精确的病变节段多次充盈CB，每次充盈后立即进行IVUS成像，以评估斑块改良情况并指导进一步治疗。手术成功定义为残余狭窄<30%且TIMI血流3级。该研究评估了重复充盈CB对斑块破裂深度和分布的剂量依赖性影响。
RODIN-CUT技术显示出良好的效果，所有病例均实现了手术成功，支架扩张得到增强且并发症极少。该技术的简单性、成本效益和可重复性使其成为治疗严重钙化冠状动脉病变的可行选择。需要进一步的大规模研究来验证这些发现，并将RODIN-CUT技术确立为复杂钙化病变的标准治疗方法。
