How should a cutting balloon be deflated?

• A. Slow controlled deflations to allow proper rewrapping
• B. Rapid deflation to minimize time
• C. Deflate after full rewrap occurs
• D. Deflate in the middle of inflation only

Answer: (A)

Deflate slowly and in a controlled manner because a cutting balloon has micro-blades that score the lesion as it inflates. A gradual collapse lets the balloon and blades retract smoothly and lets the balloon rewrap around the catheter shaft, which helps prevent snagging of tissue on the blades and reduces the risk of dissection or vessel injury when you withdraw the device. Rapid deflation can cause abrupt recoil or tissue snagging, making withdrawal riskier. Deflating in the middle of inflation isn’t appropriate because inflation should be completed to achieve the desired plaque modification before the balloon is collapsed. Waiting for some delay to rewrap before deflating isn’t standard practice either; the deflation phase should begin promptly after inflation ends to ensure safe withdrawal.