Which inflation approach is recommended for a cutting balloon?

• A. Slow/controlled inflations
• B. Rapid inflations to nominal
• C. Inflation to nominal in a single step
• D. Inflation at multiple high pressures simultaneously

Answer: (A)

Controlled, gradual inflation is essential when using a cutting balloon because the device's microblades score the plaque as the balloon expands. This slow expansion lets the blades make precise incisions in the plaque rather than tearing tissue or causing abrupt vessel rupture, reducing the risk of dissection and other injury. It also promotes better lumen gain with less distal embolization and recoil, since the scoring helps modify the plaque in a controlled way before full dilation. Rapid inflation to nominal or inflating to nominal in a single step can produce uncontrolled tearing or sudden vessel wall stress, increasing the risk of complications. Inflation at multiple high pressures simultaneously isn’t a recognized or advantageous technique for cutting balloons.